2009 Radiology Exam - Thorax Case 2

Candidates were given left lateral and VD views of the thorax of an 11 year old Labrador retriever spayed female; the history was lethargic, slow to rise.

See images below. Click to enlarge.

Observation (Radiographic Findings):

• soft tissue mass in right cranial lung lobe
• periosteal reaction along the diaphyseal cortices of both humeri
• rounded soft tissue mass in ventral aspect of cranial abdomen on left lateral view

Synthesis (Radiographic diagnosis):

• Probable primary pulmonary neoplasm of the right cranial lung lobe; metastatic neoplasm, abscess, granuloma, possible but less likely
• Hypertrophic osteopathy, secondary to pulmonary pathology
• Possible cranial abdominal mass (unlikely to be gastric pylorus, since this is a left lateral recumbent view)

Recommendation:

• Radiographic examination of extremities to confirm HO
• FNA or biopsy of lung mass
• Abdominal radiographs and/or ultrasound to evaluate for suspected mass
• CT of thorax to evaluate for evidence of metastases, particularly if surgical removal of large mass is to be considered