Case Study

CT – Post trauma soft tissue nasal thickening with lymphadenopathy in a 7 year old MN Labrador Retriever mix

This 7 year old MN Labrador mix has a history of right sided epistaxis after head trauma 2 weeks previously. Biopsy of nasal tissue diagnosed squamous cell carcinoma. ALKP 676.

DX

Mild soft tissue thickening inner surface right nostril  Lymphadenopathy right submandibular lymph node

Image Interpretation

CT of the skull –

The inner dorsal and medial aspect of the right nostril presents mild thickening and irregularity in comparison to the left nostril.

There is no evidence of a mass lesion inside the nasal cavity and no evidence of conchal or turbinate destruction

Mild enlargement of one right submandibular lymph node is noted, the short-to-long-axis-ratio is maintained normal with < 0.5.

Outcome

No evidence of a mass lesion inside the nasal cavity. The very subtle changes of the right nostril are very unlikely to be neoplastic in origin. Clinical correlation is warranted. Should there be any suspicion of a neoplastic change repetition of the tissue sampling for pathohistology is advised from that region. This may be combined with immediate excision of the affected area.
The odds of unspecific reactive right-sided submandibular lymphadenopathy is high. The changes do not meet malignancy criteria. FNA sampling of the enlarged right submandibular lymph node is advised for further workup.