– 6 year old MN, obese (80kg) Rottweiller with history of cough responsive to antibitoics in the past
– presented to rDVM for unrelated surgical procedure but he did not like the sound of his lungs so took chest rads in which a dense alveolar pattern was note in the left cranial lung lobe
– ultrasound showed lung consolidation in the region which had the angular shape of a lung lobe; could be seen sliding off the heart surface; LA normal in size
– no pleural or pericardial fluid appreciated; no mediastinal LN’s seen
– 6 year old MN, obese (80kg) Rottweiller with history of cough responsive to antibitoics in the past
– presented to rDVM for unrelated surgical procedure but he did not like the sound of his lungs so took chest rads in which a dense alveolar pattern was note in the left cranial lung lobe
– ultrasound showed lung consolidation in the region which had the angular shape of a lung lobe; could be seen sliding off the heart surface; LA normal in size
– no pleural or pericardial fluid appreciated; no mediastinal LN’s seen
– u/s guided FNA’s performed and submitted for cytology and culture
DDX: pneumonia (perhaps aspiration?) or pnemonitis, neoplasia, contusion (but no history of trauma)
Would you lean more toward infection or neoplasia? A CT and full abdominal ultrasound was recommended.
Comments
This is hepatization of the
This is hepatization of the lung with residual air bangs in the cranial aspect of this lung lobe. The lung capsule is uniform and not distorted so I would be leaning toward lung necrosis penumonia then lung sarcoma and less so carcinoma. FNA or core bx should tell..If this is a lobar issue then sx may resilve and CT would be best here to plan sx.
Here are some lung pathology cases form the basic search
http://sonopath.com/members/case-studies/search?text=lung+&species=All
Hi!
Yes, I completely agree
Hi!
Yes, I completely agree with Eric´s comment!
Yet, pls note that lung lobe torsion can look similar. Difference is that there is not blood flow on Doppler as opposed to pneumonia.
In pneumonia that causes this degree of consolidation you should see clear evidence of infection on FNA.
I know that this is a cran left lung lobe (this one is not typical for torsion), but we had a similar case where only the ´cranial portion of the left cran lobe was twisted.
If there is doubt, a CT is strongly indicated.
I will try and upload comparative ultrasound clips (pneumonia vs torsion) tonight.
Click this link: https://sonopath.com/forum/aspiration-pneumonia-and-lung-lobe-torsion-comparison
Peter
Thank-you Peter!
Thank-you Peter!