Radiology Packet 11

Pulmonary Patterns

7-year old MN mixed breed dog“Max”

• Hx: Presented for evaluation of a chronic intermittent cough. The cough has been getting progressively worse and is more severe at night.

7-year old MN mixed breed dog“Max”

• RF– There is a mild diffuse interstitial lung pattern that is consistent

with normal aging.– A large mass of soft tissue opacity is present in the right caudal

lung lobe.

• RD– Solitary pulmonary mass left caudal lung lobe

• R/O– Primary pulmonary tumor

2-year old cat “Smokey”

• Hx: Presented for her annual PE and vaccinations. The PE is normal but during your conversation with the owners they mention that she occasionally coughs and gags, sometimes vomiting a hairball.

2-year old cat “Smokey”

• RF– Cardiovascular structures and pulmonary parenchyma are

normal.– In the lateral view there is a mild increase in opacity in the lungs

cranial to the heart. This is the result of superimposition of the forelimb musculature over the thorax.

• RD– Normal thorax

2-year old German Shepherd

• Hx: 2 week history of coughing

2-year old German Shepherd

• RF– There is a striking pulmonary infiltrate present which is predominately

surrounding the airways, making them appear thick.– There is a peribronchial infiltrate.

• RD– Broncho-interstitial pulmonary pattern with bronchial pattern being

primary

• R/O– Allergic lung disease– Parasitic lung disease– PIE– Bronchitis

10-year old Labrador“Luke”

• Hx: Presented for collapse. Blood work is pending.

10-year old Labrador“Luke”

• RF– Multiple soft tissue nodules of varying size and shape were noted scattered throughout the lung

fields.– There is an increase in cranio-caudal width of the heart and an increase in sternal contact on the

lateral view.– The trachea appears to be elevated and the heart appears elongated.– There appears to be some bulging in the area of the left atrium.– The DV view suggests rounding of the heart with a slight deviation to the left side.

• RD– Cardiomegaly– Multiple soft tissue pulmonary nodules r/o Pulmonary metastatic disease

• R/O– Primary cardiac disease– Active pericardial effusion ( Radiographs taken the day before showed a much smaller heart)– Hemangiosarcoma involving the right atrium– Ectopic thyroid tumor

• Next– Cardiac ultrasound

1.5 year old German Shepherd

• Hx: hit by car

1.5 year old German Shepherd

• RF– The cardiovascular structures are within normal limits.

– The pulmonary vessels are within normal limits.

– A prominent skin-fold is noted in the right hemi-thorax and may be mistaken for pneumothorax.

– The extra-thoracic structures are within normal limits.

• RD– Normal thorax

2-year old Border Collie“Jig”

• Hx: Dyspnea and lethargy

2-year old Border Collie“Jig”

• RF– Severe, diffuse (coarsely) nodular interstitial infiltrate.– A focal, irregular soft tissue opacity is noted over the cranioventral heart

border on the lateral view, localized to the left cranial lung on the VD view.

– Pleural fissure lines are present.

• RD– Poorly circumscribed left cranial lobe mass and diffuse severe coarsely

nodular interstitial infiltrate

• R/O– Neoplasia– Fungal disese

8-year old mixed breed dog“Sandy”

• Hx: Severe respiratory distress

8-year old mixed breed dog“Sandy”

• RF

– Severe infiltrate involving the lung field.

– Heavy interstitial to alveolar infiltrate.

– Loss of vessel clarity.

– Enlarged cardiac silhouette. Increased width of the heart, especially in the area of the right ventricle.

– Air lucency between the right lung, which is retracted from the chest wall.

– Visualization of the aorta and esophagus indicative of pneumomediatinum.

• RD

– Severe diffuse pulmonary infiltrate and enlarged right ventricle

– Mild pneumothorax

• R/O

– Cor pulmonale

– Granulomatosus

• Next

– Lung biopsy or aspirate

4-year old FS German Shepherd

• Hx: Presented with lethargy and some coughing. Peripheral lymph node enlargement is noted on PE.

4-year old FS German Shepherd

• RF– A diffuse heavy interstitial pulmonary infiltrate is present. A few areas are becoming very

opaque, indicating consolidation and early alveolar infiltrates.– A thin pleural fissure line is noted on the lateral view over the caudal waist region.– Heart and vessels are normal.– Bone reaction seen on the left 6th to 8th rib

• RD– Diffuse heavy interstitial pulmonary pattern

• R/O– Pulmonary edema– Hemorrhage– Inflammatory infiltrate

• Pneumonia or allergic– Diffuse neoplastic infiltrate

• Next– Aspirate lungs– Rib biopsy