Radiology Packet 8.ppt

7/30/2019 Radiology Packet 8.ppt

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Radiology Packet 8

Pulmonary Pattern - Interstitial


2/23

8-year old Labrador Retriever

Jake Hx: Presented for progressive stranguria. Abdominal radiographs

were obtained and a small portion of the caudal lung fields were

visible so thoracic films were taken.


3/23


4/23

8-year old Labrador Retriever

Jake RF

The cardiac silhouette and pulmonary vessels are slightly small.

The bronchial walls are visible as thin, opaque lines extending into the periphery of the lungs.

There is an overall increase in lung opacity that causes the pulmonary vessels to be poorlyseen.

There are multiple small, poorly defined interstitial nodules.

RD The predominant lung pattern is reticulonodular interstitial

Changes are in the interstitium and are both reticular and nodular

Mixed bronchial pattern is also present

R/O Metastatic neoplasia

Prostatic adenocarcinoma

Mammary adenocarcinoma

Hemangiosarcoma

Pulmonary lymphoma

Fungal pneumonia

Next Abdominal ultrasound with special emphasis on the urinary bladder and prostate.


5/23

6-year old Labrador cross

Sam Hx: Recurrent fevers. The fevers have occurred intermittently for the

last 12 months and are responsive to treatment with antibiotics.


6/23


7/23

6-year old Labrador cross

Sam RF

Multiple variably sized nodules present.

In the lateral view the largest nodule is seen overlying the diaphragm.

The liver is slightly small.

RD Multiple interstitial lung nodules

R/O

Metastatic neoplasia

Primary pulmonary neoplasia (unlikely) Abscess/granuloma formation

Next

Abdominal radiographs and/or ultrasound


8/23

6-year old Standard Poodle

Hx: Sudden onset of coughing


9/23


10/23

6-year old Standard Poodle

RF There is a diffuse nodular interstitial lung pattern.

Interstitial nodules are extremely tiny and there are many of them. In some areasthey coalesce and form a heavy interstitial pattern.

In the VD view the central area of the thorax is more opaque due to overlying softtissues and the line in the left hemi-thorax is the result of superimposition of askin fold.

RD Diffuse nodular interstitial lung pattern with evidence of mineralization of

interstitial nodules

R/O

Pneumoconiosis Fungal pneumonia


Next Fine needle aspirate of lung tissue


11/23

9-month old Labrador Retriever

Amos Hx: Castrated at the age of 7 months and has had a cough since that time.

The cough is noted to be non-productive and has progressed in the last 2

weeks. Thoracic radiographs were obtained.


12/23


13/23

9-month old Labrador Retriever

Amos RF

In the lateral view there is an unusual appearance to the cranial heart border.This is the result of an exposure made during systole.

In the VD view the right heart appears prominent. This is the result of slightrotation in positioning.

There is a moderate diffuse broncho-interstitial lung pattern. The overall increasein pulmonary opacity is the result of interstitial infiltrates.

Bronchial markings extend well beyond the hilar area.

RD Moderate diffuse broncho-interstitial lung pattern

R/O

Parasitic lung disease Allergic lung disease

Next Fecal evaluation for lungworm larvae (Baermann)


14/23

4-year old German Shorthair

Pointer Autumn Hx: 2 episodes of mild weakness/collapse associated with intense exercise.

A persistent cough is also reported. A systolic cardiac murmur with the point

of maximal intensity at the aortic valve was noted a year ago.


15/23


16/23

4-year old German Shorthair

Pointer Autumn RF

In the lateral view the heart appears widened and the cranial border is slightly squareindicating right ventricular enlargement.

Buchanan measurement is 11.4 so the increase in size is mild.

In the VD view there is rounding of the right ventricular area.

There is a moderate diffuse interstitial pulmonary pattern.

RD

Mild right-sided cardiac enlargement Moderate diffuse interstitial lung pattern with occasional bronchial markings

R/O Tricuspid valve insufficiency

Cor pulmonale

Lungworm infestation

Interstitial pneumonia

Interstitial changes due to prior pulmonary disease that is now inactive

Next Echocardiography

Baermann fecal exam


17/23

9-year old castrated male Shih Tzu

Hx: Chronic cough of 3 weeks duration. Recently the dog has also beenmildly anorexic and the owners thing the dog has lost weight. The rDVMhad radiographied the thorax and diagnosed an esophageal diverticulum.


18/23


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20/23

9-year old castrated male Shih Tzu

RF A large, ~ 6cm circular mass is present in the dorsal part of the left caudal lung lobe.The

mass has a radiolucent center surrounded by a soft-tissue opacity outer portion.

A second small mass, about 4cm x 3cm is present in the dorsal portion of the right craniallung lobe. The mass also has a radiolucent area.

Several other smaller, irregular soft tissue opacity nodules are present in the ventral parts ofthe right middle and left caudal lung lobes

RD 2 cavitated masses within the pulmonary parenchyma along with a nodular interstitial pattern

R/O Primary lung tumor with pulmonary metastasis


Pulmonary abscesses or granulomas

Next Transtracheal aspirate or bronchoalveolar lavage

CBC

Fine needle aspirate of mass using US guidance


21/23

7-year old Beagle

Dawg Hx: Presented with a chronic cough and exercise intolerance. He

has been this way for several years and the clinical signs have not

progressed.


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7-year old Beagle

Dawg RF

The heart shows mild widening and increased sternal contact in the lateral viewand rounding of the 5 to 9 oclock region in the VD view.

There is diffuse heavy interstitial infiltrate noted causing the vessels margins tobe indistinct.

Several thin pleural lines are present likely the result of pleural fibrosis.

The diaphragm is cranially displaced with the lumbodiaphragmatic andgle at T10-11 in the lateral view.

RD Mild right-sided cardiac enlargement

Diffuse heavy interstitial lung pattern

Mild bronchiectasis

R/O Pulmonary fibrosis

Cor pulmonale

Next Follow-up radiographs to monitor progression

Documents

Radiology Packet 8.ppt