Case of the week 7.17.23
Publication Date: 2023-07-17
History
3 year old poodle. Increased respiratory rate. Oxygen dependent
3 images
Findings
Left lateral, right lateral, and ventrodorsal thoracic radiographs are available for review.
There is a severe miliary pattern throughout the lungs. There is a large (approximately 3 cm diameter), soft tissue opaque lesion in the ventral aspect of the right middle lung lobe. This lesion has a tapered lateral margin that appears t appears more rounded and mass-like in the subsequent study. The cardiovascular structures and trachea are normal. No abnormalities are detected in the pleural space or mediastinum. The included skeletal structures and cranial abdomen are unremarkable.
Diagnosis
Diffuse miliary pattern. Fungal disease (e.g. blastomycosis or histoplasmosis) is considered most likely. Less likely metastatic neoplasia cannot be entirely excluded. The larger soft tissue opaque lesion in the right middle lung lobe may represent focal collapse/atelectasis secondary to bronchial obstruction, a large fungal granuloma, or less likely a neoplastic mass (e.g. primary pulmonary carcinoma).
Discussion
The patient was confirmed to have blastomycosis.
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