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