Case Study

CT- Chronic bilateral otitis media and externa, right bulla polyp and bilateral tonsillitis in a 10 year old MN Chinese Crested dog

This 10 year old MN Chinese Crested dog presented with a history of with a lump on the head that is pruritic and is bothering the dog, bleeding at times. Also long term problem of nasal congestion, nasal discharge.

Physical Exam: There is thickening and dryness of the pads noted. Left eye squinting and corneal scar present which owner is treating. Nasal stridor. 3 mm wart like lesion on dorsum of head.

DX

Small subcutaneous soft tissue nodule. The findings further suggest development of a chronic inflammatory polyp within the right bulla and/or external ear canal. Signs of chronic otitis media and externa are seen on both sides. There is reactive lymphadenitis of the mandibular lymph nodes. bilateral tonsillitis and mild accumulation of fluid within the nasal fundus

Image Interpretation

CT of the head, plain and post contrast-
A small subcutaneous soft tissue nodule is seen dorsal to the frontal bone within a
midlne position. The attenuation and enhancement features of the nodule are similar to
the surrounding soft tissue. The underlying bone is within normal limits.
The horizontal part of the right ear canal is mildly expanded and contains soft tissue
attenuating material, which reveals slight peripheral enhancement. The left tympanic
bulla is filled with material that shares similar features.
A mid amount of hypoattenuating and non-enhancing material is seen within the
horizontal part of the left ear canal as well as on the floor of the left bulla.
There is reactive hyperplasia of the submandibular lymph nodes.
A mild maloccclusion with the lower jaws deviating to the left and inferior
brachygnathia is noted which may be partly due to the position of the tracheal tube.
The rostral palatinal raphe reveals moderate generalized swelling which is likely to be
secondary to the malocclusion.
Both pharyngeal tonsils reveal mild symmetric enlargement and eversion. A mild amount of foamy hypoattenuating material is accumulated within the ventral
nasal meatus and nasal fundus.

Outcome

Even though the CT does not reveal any
malignancy criteria a neoplasia such as mast cell or basal cell tumor is still a potential.
Excisional biopsy with safety margins of 1 cm where possible is recommended.Full
otsocopic workup is recommended. There is bilateral tonsillitis and mild accumulation of fluid within the nasal fundus,
which is likely to be a function of a mild unspecific chronic inflammation of the upper
respiratory tract and may contribute to the clinical signs. Symptomatic treatment is
recommended.