The patient has a one month history of sinus congestion, with episodes of stertorous breathing. No improvement with antibiotics.
The patient has a one month history of sinus congestion, with episodes of stertorous breathing. No improvement with antibiotics.
CT of the head, pre- and post-contrast series – Within both nasal cavities a moderate amount of non-enhancing soft tissue attenuating
material precipitates within the ventral thirds and occupies the nasal fundus as well as
the rostral aspect of the nasopharynx. There is no turbinate destruction. The nasal
septum and nasal bones are intact. A mass effect is not evident.
Mild irregular thickening of the soft palate and caudodorsal pharyngeal wall is noted.
A focal mineralization of 4 x 3 mm is seen within the right caudal aspect of the soft
palate consistent with a dystrophic mineralization.
The right frontal sinus is not patent which is a common congenital variation of normal
anatomy with no known clinical significance. The left frontal sinus is patent and within
normal limits.
Both medial retropharyngeal lymph nodes present moderate enlargement, rounded
shape and heterogenous contrast enhancement. The surrounding tissue reveals mild fat
stranding. The submandibular lymph nodes show mild symmetric enlargement.
All findings are present
bilaterally. The accumulation of secretions within the nasopharynx leads to upper
respiratory tract obstruction.
Both fungal and bacterial infections have to be considered as underlying causes. Bacterial is lower for potential because of the lacking response to antibiotic therapy
and the marked lymphadenitis. It is known that there is an overlap between computed
tomographic features of rhinitis and nasal neoplasia in cats but findings specific for
neoplasia are lacking here.
For further diagnostic workup rhinoscopic evaluation with pertinent tissue/exudate
sampling and histopathological and cultural testing is recommended as well as
(ultrasound guided) aspiration of the (right) medial retropharyngeal lymph node for
cytology & culture.
