Case of the week 2.4.19
Publication Date: 2019-02-04
History
6 year old male castrated golden retriever. Increased respiratory effort
5 images
Findings
Opposite lateral and dorsoventral radiographs of the thorax and lateral radiographs neck are acquired by emergency service.
Neck:
There is marked swelling and edema of the cranioventral neck, caudal to the mandible, with multiple round soft tissue opacities in the area of the submandibular lymph nodes.
There are large soft tissue opaque swellings of the retropharyngeal region, dorsal to the hyoid apparatus. There is thickening of he included caudal soft palate.
There is an incidental redundant dorsal tracheal membrane.
There is cranial mediastinal lymphadenopathy and suspect sternal lymphadenopathy.
On the dorsoventral view, there is increased soft tissue opacity in the plane of the tracheobronchial lymph nodes and left atrium, which cannot be correlated on the lateral views.
The cardiac silhouette is otherwise normal. There is a diffuse marked bronchial and almost miliary/reticular pattern. The pulmonary vessels are normal.
There is diffuse enlargement of the liver.
Diagnosis
Multifocal moderate to severe lymphadenopathy (head/neck and intra-thoracic) is most suggestive of lymphoma. The pulmonary pattern is suggestive of infiltration of lymphoma.
Hepatomegaly is nonspecific and could represent benign or malignant etiologies. However, in the light of the concurrent findings lymphoma is considered likely.
Discussion
The patient was confirmed to have multicentric lymphoma and was ultimately euthanized. The necropsy confirmed the diagnosis.
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