Case of the week 7.8.19
Publication Date: 2019-07-08
History
2 year old male castrated labrador retriever. Labored breathing.
6 images
Findings
Opposite lateral and VD radiographs of the thorax. The images are acquired after removal of 1.3 L of pleural effusion.
There is moderate pleural effusion. Best seen on the left lateral views, there are multiple gas foci within the cranial ventral thoracic pleural space, consistent with recent thoracocentesis. The lung lobes are rounded and retracted from the thoracic wall. There is ill-defined increased soft tissue opacity with mildly lobular margination, within the cranial ventral and left cranial thorax, with the impression of caudal displacement of the left cranial lung lobe.
There is a diffuse mild unstructured interstitial pattern.
Although largely obscured, there are no abnormal bodies of the cardiovascular structures identified. The included cranial abdominal structures are normal.
Diagnosis
The pleural effusion is nonspecific and may represent the current working diagnosis of chylous effusion. However, the increased soft tissue opacity in the region of the cranial mediastinum is concerning for a mass which could represent neoplasia (such as thymoma, lymphoma, carcinoma) or less likely pyogranulomatous mediastinitis from pyothorax.
Computed tomography of the thorax +/- ultrasound could be performed for further evaluation.
Discussion
A CT was performed and no mass were seen. The effusion was most consitent with chylous effusion.
The dog underwent surgical treatment for idiopathic chylothorax.
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