I am reposting this as it dissappeared from the live feed when I added the lateral chest radiograph. Would like to get more opinions on as to what we could be seeing on the lateral chest rad.
- This 14yr old mn DSH belongs to a colleague. He had acute onset bilateral rear leg ataxia 3 days ago while his owners were out of town.
- This 14yr old mn DSH belongs to a colleague. He had acute onset bilateral rear leg ataxia 3 days ago while his owners were out of town.
- Bloodwork performed at the E clinic was wnl. Heart ausculted normal, normal femoral pulses, and normal CP’s. Normal BP as well. Lateral chest radiographs showed a small radio-opaque density in the cranial mediastinum, overlapping the cranial cardiac sillhouette.
- The cat was normal by the next day.
- Echo performed today is normal. I cannot obviously identify any masses or cysts in the cranial mediastinum. However, when I twist the probe from long axis on RPLVOV views, I can make an anechoic structure appear cranial to the base of the aorta.
- So, I am wondering, is this true pathology, or am I creating an artifact? Usually, mediastinal cysts will readily appear for me without any unusual manipulation of the probe. Also, I cannot make this lesion appear on LPVOV views.
I am reposting this as it dissappeared from the live feed when I added the lateral chest radiograph. Would like to get more opinions on as to what we could be seeing on the lateral chest rad.
Comments
As I think EL mentioned in
As I think EL mentioned in the original thread, I believe this is true pathology and not artifact. The radiograph shows a soft tissue opacity in the area of the ventral heart base which I think correlates to the lesion seen on ultrasound in the area of the heart base.
Possible etiologies may include heart base mass – lymphoma, aortic body tumor among other neoplasms, or possible sternal or tracheobronchial lymph node located adjacent to the heart base. To me the rest of the lungs look fairly normal for a 14 yr old cat so something like fungal disease is unlikely.
Its possible that lung interference from the LPLVOV prevents visualization of the area as the lesion only measures approx 1 cm wide.
It looks like its about 2 cm depth from the right side. Maybe FNA under sedation or anesthesia? It would be a tad risky but if something like lymphoma you could do additional testing such as flow cytometry which may help with possible treatment.
Thank you for your input. I
Thank you for your input. I am not seeing a solid lesion. What I am seeing looks cystic. If it is real, I am thinking perhaps a thymic cyst.
Could also be an incidental
Could also be an incidental cholesterol filled inclusion cyst – a differential I had recently on a similar lesion I had in the chest of a cat suggested by a radiologist.
Thanks, Jacquie. I ‘ll have
Thanks, Jacquie. I ‘ll have to look that up. Will let you know if I learn anything further on this patient.
I never heard of that either!
I never heard of that either!