Case of the week 4.23.18
Publication Date: 2018-04-12
History
12 year old Newfoundland, female spayed. 2 month history of coughing/hacking.
5 images
Findings
Orthogonal radiographs of the thorax are available for interpretation.
Within the left caudal lung lobe there is a large soft tissue opaque mass with border effacement of the diaphragm. There is a focal region of stippled mineralization within its cranioventral aspect . The mass measures approximately 17cm (W) x 9.6cm (H) x 18cm (L). It extends across midline and is causing mild displacement of the right caudal lung lobe. The mass displaces the caudal vena cava ventrally. At the cranial aspect of the mass, there is a focal alveolar pattern with a well-defined cranial margin which appears to be in the caudal subsegment of the left cranial lung lobe.
An alveoalr pattern is also present in the ventral aspect of that same lun lobe. The left caudal primary bronchus is not identified and the primary bronchus of the left cranial lung lobe is narrowed. There is a focal alveolar pattern of the right middle lung lobe seen superimposed with the ventral aspect of the cardiac silhouette on the left lateral view.
There is marked rightward mediastinal shift.
There is mild increased soft tissue opacity within the ventral pleural space, superimposed with the cardiac silhouette. Pleural fissures lines between the right cranial and middle lung lobes and between both subsegments of the left cranial lung lobes.
There is a fusiform soft tissue opacity superimposed with the dorsal lumen of the cervical trachea. There is multifocal mild spondylosis deformans of the spine.
Diagnosis
Left caudal lung lobe mass with focal region of mineralization is most consistent with a primary neoplasia such as alveolar carcinoma or histiocytic sarcoma. The changes of the caudal subsegment of the left cranial lung lobe may is concerning for metastatic disease or extension of the mass but atelectasis cannot be ruled out. Changes to the right middle lung lobe most likely represent partial collapse or atelectasis. Mild pleural effusion, probably neoplastic.
Discussion
FNAs of the mass were performed and were conclusive for chondrosarcoma or chondroblastic osteosarcoma.
The owners elected not to pursue additional procedures.
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