Case Study

RAD – Likely round cell neoplasia in a coughing 9 year old MN Labrador Retriever mix with lymphadenomegaly and interstitial lung pattern

This 9 year old MN Labrador Retriever mixed dog has a history of coughing of two weeks duration.

DX

•Possible cranial mediastinal and tracheobronchial lymphadenomegaly • Generalized unstructured interstitial lung pattern

Image Interpretation

3 view rads of the thorax –

The lung reveals a moderate non-structured increase in interstitial opacity.

A possible cranial mediastinal mass effect is noted in the region of the canial mediastinal lymph nodes and is associated with mild focal elevation of the trachea cranial to the heart. A second mediastinal opacity is noted level with the tracheobronchial lymph nodes which obscures the bifurcation and is accociated with a ventral dip and split of the arina. The mass effect on the stem bronchi may be responsible for the cough.

Outcome

Consider a diffuse secondary neoplastic infiltrate, such as with round cell neoplasia (lymphoma, histiocytic sarcoma). Infectious pneumonia (fungal, mycobacterial, bacterial) or eosinophilic bronchopneumopathy are possible differentials but lower for potential.
Consider ultrasound guided fine needle aspiration of the lung parenchyma with consecutive patient monitoring for possible pneumothorax as well as bronchoscopy with bronchoalveolar lavage for further definition.
Urine samples may be obtained to rule out fungal infection.