Small Animal Radiology and Ultrasound: A Diagnostic Atlas and Text

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Chapter Two The Thorax 209 Fig. 2-189 A 3-year-old Springer Spaniel with inappetence, dyspnea, and fever. The lateral radiograph revealed multiple pulmonary nodules (small arrows) and a mass (M) at the base of the heart. The caudal main stem bronchi are displaced ventrally (arrow) by the mass. Diagnosis: Histoplasmosis with pulmonary nodules and tracheobronchial lymph node enlargement. Fig. 2-190 A 9-year-old female Brittany Spaniel with mammary gland masses. The lateral radiograph revealed multiple calcified nodules throughout all lung lobes (small arrows). No evidence of tissue density was present in any of the nodules. The tracheobronchial lymph nodes were enlarged and calcified (curved arrows). Diagnosis: Calcified nodules and tracheobronchial lymph nodes due to prior histoplasmosis. No evidence of metastatic neoplasia was found. histoplasmosis. Calcification of pulmonary nodules may be observed as a sequela to the active disease (Fig. 2-190). Cryptococcosis, aspergillosis, and nocardiosis rarely produce pulmonary lesions. When present, they are more likely to be focal or multifocal interstitial densities or granulomas. There is a large group of miscellaneous etiologic agents that can cause disease that varies in appearance from nodular to unstructured interstitial patterns. 589-601 These include Bacillus piliformis (Tyzzer’s disease), Aspergillus, Pneumocystis carinii, Leishmania, and Mycobacterium tuberculosis.
210 Small Animal Radiolo g y and Ultrasono graphy Fig. 2-191 A 6-year-old male German Shepherd dog with exercise intolerance, anorexia, and weakness. The lateral radiograph revealed markedly dilated pulmonary arteries (arrows) and a large mass (M) in the caudal lung. Microfilaria were present on a direct blood smear. Diagnosis: Eosinophilic granuloma. At necropsy, fragments of a dead adult D. immitis were present in the mass. E O S I N O P H I L I C G R A N U L O M AT O S I S Eosinophilic granulomatosis has been described in conjunction with dirofilariasis. 520 It is typified by the presence of large nodular masses and some degree of fine linear-reticular pulmonary markings (Fig. 2-191). Eosinophilic granulomas are also part of the uncommon hypereosinophilic syndrome (Fig. 2-192). LY M P H O M AT O I D G R A N U L O M AT O S I S A N D H I S T I O C Y T O S I S Lymphomatoid granulomatosis has been described with large, nodular pulmonary masses. 602-605 Other findings that have been noted frequently include lobar consolidation and tracheobronchial lymphadenopathy. Less common findings have included mild hydrothorax, sternal and mediastinal lymphadenopathy, and a diffuse interstitial lung pattern. C O N G E S T I V E L E F T H E A RT FA I LU R E On rare occasion, congestive left heart failure will cause an acinonodular pattern (Fig. 2- 193). This pattern of fine nodular densities tends to coalesce toward the pulmonary hilus. The pattern is seen more often with chronic heart failure due to dilated cardiomyopathy than any other cause of heart failure. G R A N U L O M A O F F O R E I G N M AT E R I A L Granulomatous lesions may form around any foreign material that is inhaled and stays within the lung. Such material could include plant matter such as plant awns or iatrogenic substances (Fig. 2-194). P R I M A RY P U L M O N A RY N E O P L A S I A Differentiating primary from metastatic neoplasia or other forms of nodular pulmonary disease is difficult. Although solitary nodules are more likely to be primary neoplasms, the possibility of a solitary metastasis or granuloma cannot be excluded. Bronchogenic carcinoma is the most common tumor type. Bronchogenic carcinomas usually arise in the periphery of the lung and usually are solitary (Figs. 2-195 and 2-196). 541,544,606,607 Necrosis within the center of the mass combined with communication with an airway may result in air accumulation within the soft tissue–dense mass. Cavitation may be evident radiographically as a decreased (air) density within the tissue-dense mass. Cavitation is reportedly more frequent in bronchogenic carcinoma and squamous cell carcinoma. It may also occur within pulmonary abscesses, traumatic cysts, or hematomas. In
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SAUNDERS An Imprint of Elsevier Sci
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C H A P T E R O N E Introduction GE
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Chapter One Introduction 3 Fig. 1-1
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metal. Soft tissues or organs surro
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26 Small Animal Radiolo g y and Ult
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A B C Fig. 2-63 A 10-year-old male
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Fig. 2-101 A 7-year-old male mixed
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Fig. 3-234 A 7-year-old female Brit
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Fig. 4-59 A 9-year-old female Russi
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Fig. 4-73 A 2-year-old female Saint
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Fig. 4-97 A 10-year-old male mixed
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Fig. 4-107 A 4-year-old male Chow C
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I N D E X A Abdomen, abnormal prese
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Index 729 Bone, cysts of, 525-527,
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Index 731 Ear, abscess of—cont’
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Index 733 Hydrocephalus—cont’d
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Index 735 Lungs. See also Pulmonary
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Index 737 Pregnancy, determination
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Index 739 S-shaped aortic deformity
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Small Animal Radiology and Ultrasound: A Diagnostic Atlas and Text

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