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CT – Neoplasia of the cardiac base with metastatic spread to mediastinal lymph nodes in a 9 year old FS ShiTzu

Case Study

CT – Neoplasia of the cardiac base with metastatic spread to mediastinal lymph nodes in a 9 year old FS ShiTzu

This 9 year old FS Shih Tzu presented with a known cardiac mass, and stable valvular disease. CT to determine surgical resectability and staging to identify any metastatic disease in chest or abdomen.

This 9 year old FS Shih Tzu presented with a known cardiac mass, and stable valvular disease. CT to determine surgical resectability and staging to identify any metastatic disease in chest or abdomen.

DX

• Neopasia of the cardiac base • Evidence of metastatic spread to the cranial mediastinal lymph nodes • No evidence of pulmonary interstitial or abdominal metastatc spread • Chronic hypercalcemic nephropathy with non-obstructive renal and urinary bladder calculi as well as chronic cystitis • Polycystic renal disease

Image Interpretation

CT of the thorax and abdomen – 

Thorax: A large infiltrative non-uniformly enhancing soft tissue mass of 5 x 5 cm is  seen at the cardiac base entrapping the aortic root, descending and ascending aorta including the brachycephalic trunc. There is a significant mass effect on the surrounding cardiac and vascular anatomy including the lumen of the left ventricle. Only scant pericardial effusion is noted. One of the cranial mediastinal lymph nodes reveals severe enlargement with loss of the regular short-to-long-axis ratio and non-uniform contrast enhancement. Several pleural plugs and ditzels are noted throughout the lungs. There is no evidence of metastatic spread to the pulmonary interstitium.

Abdomen: 

Both kidneys present signs of hypercalcemic nephropathy with accumulation of non-obstructive calculi within the renal pelvis as well as multifocal expansile cortical cysts up to 7.5 mm diameter. The nephrogram is symmetric between the right and left kidney. The renal pyelogram is delayed respectively. Multiple large, non-obstructive urinary bladder calculi and signs of chronic cystitis with urinary bladder wall thickening are noted. 

Outcome

The neoplasia of the cardiac base is in a non-resectable position.

Patient Information

Patient Name : Izzy Smeriglio/MPI
Gender : Female, Spayed
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 16_00057

Exam Finding

  • Heart Murmur

Images

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CBC

  • WBC, High