A 2-year-old FS Beagle mixed breed. Clinical findings: 2 chest nodules. Fever of unknown origin. Vomiting/diarrhea. Altered CBC/Chem/UA values: WBC 20,000. TP 8.3. BUN subnormal at 5. Globulins sl. Elevated. Coag-wnl. HWT-neg.
A 2-year-old FS Beagle mixed breed. Clinical findings: 2 chest nodules. Fever of unknown origin. Vomiting/diarrhea. Altered CBC/Chem/UA values: WBC 20,000. TP 8.3. BUN subnormal at 5. Globulins sl. Elevated. Coag-wnl. HWT-neg.
Ultrasound-guided FNA of the lung nodules were performed without complication. FNA of the mass in the region pancreas would have been ideal in this patient. U/S-guided FNA of the lung nodule revealed blastomycosis. The patient lived in a blast-free region for > 1 year but had been adopted before that so the origin of infection was likely from prior residence in a blasto endemic region.
US guided fna of the lung lesion revealed blastomycosis.
Neoplasia, possibly pancreatic or round cell origin with pulmonary metastasis. Fungal disease, pancreatitis and pneumonitis.
The gastric wall was slightly thickened in this patient. The remainder of the intestinal tract was unremarkable. The mesenteric lymph node was enlarged with distorted architecture and a pericapsular inflammatory pattern. The lymph node measured 2.15 x 1.3 cm with similar echogenicity to the lung nodules. A regional, mixed, hypoechoic area in the pancreas was also noted in this patient creating a 2.0 x 2.0 cm mass. This is likely of pancreatic origin or overlying distorted lymph node.
Thorax: The left thorax in this patient revealed a hypoechoic lung nodule that measured 1.25 x 1.09 cm. lung origin is confirmed by the peripheral air interface in the lesion.
