Thorax
This work is licensed under the Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/us/ or send a letter to Creative Commons, 171 Second Street, Suite 300, San Francisco, California, 94105, USA.
Publication Date: 2008-11-05
| Document | Image Export |
|---|---|
History
10 year old male neutered Husky cross with difficulty breathing and cough for a few days.
Findings
There is marked ventral and leftward displacement of the trachea. Both the cranial and caudal mediastinum is widened on the d/v projection.
There is near complete lysis of the right 4th rib, visible on the lateral and d/v projections. The pleura of the right hemithorax appears irregular, resulting in an undulating lung border on that side, overlying the 5th , 6th and 7th ribs. The 3rd-5th ribs on the right are widened and displaced.
There is moderate pleural effusion and air bronchograms on the left lateral projection, indicating atelectasis or infiltration of the right cranial and right middle lung lobes.
DDx
Mediastinal masses, rib mass, possible pleural masses and pleural effusion.
- Osteosarcoma with pleural and mediastinal metastasis
- Histiocytic sarcoma or other round cell neoplasia
- Fungal disease is less likely
Diagnosis
CT scan revealed lysis of the right 3rd rib and part of the associated vertebral body, dorsal mediastinal mass with heterogeneous contrast enhancement, multiple pleural nodules, sternal lymphadenopathy, and multifocal pulmonary nodules throughout lungs.
Fine needle aspirates of the rib and cranial mediastinal mass may represent osteosarcoma or histiocytic sarcoma. Immunohistochemistry is pending for final diagnosis.