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CT – Nasopharyngeal soft tissue neoplasia with osteolysis in a 10 year old M Basset Hound with a history of lymphoma

Case Study

CT – Nasopharyngeal soft tissue neoplasia with osteolysis in a 10 year old M Basset Hound with a history of lymphoma

This 10 year old Basset Hound dog has a history of lymphoma diagnosed 6 months ago. Has been treated with chemotherapy. Presented with nasal discharge, eye discharge with corneal irritation and cloudiness, pain on opening of the mouth.

This 10 year old Basset Hound dog has a history of lymphoma diagnosed 6 months ago. Has been treated with chemotherapy. Presented with nasal discharge, eye discharge with corneal irritation and cloudiness, pain on opening of the mouth.

Image Interpretation

CT of the head- Varying degrees of adenomegaly at up to 4.0 cm diameter are noted for the lymph nodes of the head including the medial retropharyngeal, submandibular and parotid nodes. The affected lymph nodes present with increased short-to-long-axis ratio, asymmetric enlargement and heterogeneous contrast enhancement. Regional fat stranding is noted in the proximity of the nodes. The findings are more pronounced on the left side.

There is a dorsal nasopharyngeal soft tissue mass measuring 7 mm in diameter with secondary aggressive permeative osteolysis at the hamulus and the base of the pterygoid. One focus of osteolysis and amorphous osteoproliferation extends to the right basisphenoid and petrosal part of the temporal bone and involves the exit zone of the peripheral branches of the right trigeminal nerve.

Both nasal cavities present mild thickening of the mucosal lining and mildly increased secretions without signs of turbinta destruction

Both tympanic bullae and the most medial aspect of the ear canals are filled with soft tissue attenuating material. The material within the ear canals reveals mild contrast enhancement. Both ear canals present marked medial tapering and generalized wall thickening.

DX

The computed tomographic findings are consistent with the reported lymphomatous enlargement of the peripheral lymph nodes. Moreover there is a malignant soft tissue neoplasia causing aggressive polyostotic osteolysis which is most likely to be another manifestation of the known lymphoma.

Outcome

Theoretically other primary neoplasia – such as squamous cell carcinoma, melanoma,
fibrosacroma or other – is a possible differential diagnosis. There is mild unspecific bilateral rhinitis, which is likely to be a function of the nasopharyngeal stenosis owing to the mass effect.
The soft tissue and bone changes involve the exit zone of the right trigeminal nerve
branches. Secondary impingement or infiltration has to be considered. Bilateral signs of otitis media et externa are noted. The patient appears to be
predisposed to secretory Otitis due to the narrow conformation of the ear canals.
Emerging inflammatory polyp formation within the ear canals has to be considered as a
differential diagnosis for the contrast enhancing soft tissue next to the exit zone of both
tympanic bullae.

Patient Information

Patient Name : Bubba/Bluegrass
Gender : Male, Intact
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 16_00053

Clinical Signs

  • Nasal discharge mucoid

History

  • Neoplasia

Exam Finding

  • Ocular abnormality
  • Ocular Discharge
  • Pain

Images

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Clinical Signs

  • Nasal discharge mucoid