Case Study

CT – Prominent iliac lymph node, otherwise normal CT screening in a 2 year old MN Belgian Malinois with weight loss and episodic fever

This 2 year old MN Belgian Malinois has a history of episodes of fever, lethargy, weakness in the legs and some seizure-like activity. Wt loss. There is a mild protrusion of the right eye globe with decreased retropulsion and mild prolapse of the third eyelid.

DX

The CT study does not show macromorphologic changes that explain the history of fever and weight loss

Image Interpretation

CT of the skull, thorax and abdomen-

The orbital structures present bilateral symmetry except for the rotation of the bulbi related to the general anesthesia. Intraocular changes cannot be ruled out based on CT. The left medial iliac lymph node is prominent in comparison to the right side, even though the short-to-long-axis-ratio is maintained normal with < 0.5.

Outcome

However, a prominent left iliac lymph node was detected and
ultrasound guided FNA samples are recommended for completeness, even though the
underlying cause may be obscured by the prednisone therapy.
Complementary CSF examination is advised. In case of the strong suspicion of
intraparenchymal structural CNS changes an MRI study of the head may be considered
as well.