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1.
Computed tomography (CT) is the primary imaging modality used to investigate human patients with suspected malignant or inflammatory pleural effusion, but there is a lack of information about the clinical use of this test in dogs. To identify CT signs that could be used to distinguish pleural malignant neoplasia from pleuritis, a retrospective case‐control study was done based on dogs that had pleural effusion, pre‐ and postcontrast thoracic CT images, and cytological or histopathological diagnosis of malignant or inflammatory pleural effusion. There were 20 dogs with malignant pleural effusion (13 mesothelioma, 6 carcinoma; 1 lymphoma), and 32 dogs with pleuritis (18 pyothorax; 14 chylothorax). Compared to dogs with pleuritis, dogs with malignant pleural effusions were significantly older (median 8.5 years vs. 4.9 years, P = 0.001), more frequently had CT signs of pleural thickening (65% vs.34%, P = 0.05), tended to have thickening of the parietal pleura only (45% vs. 3%, P = 0.002) and had more marked pleural thickening (median 3 mm vs. 0 mm, P = 0.03). Computed tomography signs of thoracic wall invasion were observed only in dogs with malignant pleural effusions (P = 0.05). There were no significant differences in pleural fluid volume, distribution or attenuation, degree of pleural contrast accumulation, amount of pannus, or prevalence of mediastinal adenopathy. Although there was considerable overlap in findings in dogs with malignant pleural effusion and pleuritis, marked thickening affecting the parietal pleural alone and signs of thoracic wall invasion on CT support diagnosis of pleural malignant neoplasia, and may help prioritize further diagnostic testing.  相似文献   

2.
A 12-year-old neutered female Pembroke Welsh Corgi had a 2-month history of a progressive, productive cough nonresponsive to therapy. Mild pleural effusion, right middle lung lobe collapse, and multiple subpleural nodular lesions were detected in thoracic radiographs and computed tomography (CT) images. Histopathologic diagnosis of the pleural nodules was mesothelioma. Mesothelioma should be considered in patients where pleural masses are detected in radiographs or CT images.  相似文献   

3.
A 10‐year‐old female spayed Dachshund was referred with progressive coughing for 1 month. The dog was tentatively diagnosed with right middle lung torsion based on pleural effusion, vesicular emphysema, abruptly ending bronchus in consolidated right middle lung, and no contrast enhancement of the affected lobe on radiography and computed tomography (CT). There was no evidence of torsion upon thoracotomy, and histological examination confirmed lobar pneumonia. The CT images were reevaluated using minimum intensity projection and revealed normal bronchial courses. The minimum intensity projection technique can be to assist in evaluation of the bronchial tree for dogs with suspected lung lobe torsion and other pulmonary diseases.  相似文献   

4.
A 10‐year‐old, female spayed mixed‐breed or cross‐bred dog was referred to the Small Animal Teaching Hospital of the University of Liverpool due to tachypnea, dyspnea, and pleural effusion not responding to diuretics and antibiotics. The chest was drained and cytology of the pleural fluid was consistent with a modified transudate with presence of atypical cells initially attributed to mesothelial hyperplasia and dysplasia. Computed tomography detected, in addition to the bilateral pleural effusion, diffuse pleural thickening, multiple pleural and pulmonary nodules, and a mineralized and lytic mass in the left scapula. Imaging findings were suggestive of a primary bone tumor with intrathoracic metastasis. Cytology of the left scapular and pleural masses revealed a malignant neoplasm highly suggestive of osteosarcoma. The diagnosis was confirmed by demonstration of a positive cytochemical reaction for alkaline phosphatase on prestained cytology slides. This finding prompted review of the initial interpretation of the pleural effusion cytology. The presence of neoplastic osteoblasts in the thoracic fluid was identified by a combination of cytochemistry, cell pellet immunohistochemistry, and transmission electron microscopy findings. In this report, a multidisciplinary integrated diagnostic approach was used to diagnose and confirm a neoplastic pleural effusion due to osteosarcoma metastasis in a dog.  相似文献   

5.
A 10‐year‐old, female spayed Shih Tzu was presented due to weight loss, increased respiratory effort and lethargy, determined to be secondary to a congenital para‐esophageal diaphragmatic defect with partial herniation of the stomach and spleen. Four days following reduction surgery of the displaced abdominal organs thoracic effusion developed. Thoracic fluid evaluation revealed a cell‐rich, protein‐poor modified transudate with neutrophils, reactive mesothelial cells, and atypical epitheloid cells which occasionally appeared to be keratinizing, consistent with neoplastic exfoliation. Thoracic effusion recurred 2 days later, with similar characteristics as the initial sample. Computed tomography (CT) indicated consolidation and displacement of the right middle and accessory lung lobes. Exploratory thoracic surgery demonstrated a thickened, hyperemic right middle lung lobe, and thickened pericardial diaphragmatic ligament. Histologic evaluation of these tissues identified a primary pulmonary adenosquamous carcinoma with intravascular and pleural invasion. Based on these cytologic, histologic, and clinical findings, we conclude that primary pulmonary carcinomas may involve superficial thoracic structures and exfoliate into a thoracic effusion.  相似文献   

6.
A 3‐year‐old Himalayan cat was presented with respiratory distress. Radiography showed multiple gas opacity foci, with the locations dependent on patient positioning, and severe pleural effusion with a contralateral mediastinal shift. A large volume of fluid and air was aspirated, and the fluid components were consistent with a nonseptic exudate. A pulmonary mass, pleural nodules, and an air–fluid interface with air bubbles trapped in fibrous septations were identified using thoracic ultrasonography and CT. The cat died 2 days after imaging studies. Necropsy revealed tension pyopneumothorax caused by pulmonary carcinoma and multiple pleural metastases.  相似文献   

7.
Three horses with clinical signs compatible with pleural effusion were examined with diagnostic ultrasound. In one of the three horses, confirmed septic pleural effusion was monitored with ultrasound during a successful treatment regimen. Eficacy of thoracentesis and detection of recurrence of fluid were readily determined. In the second horse, diagnosis of diffuse pleural neoplasia (lymphosarcoma) was made. In the third horse presented for pleural effusion, the effusion was documented and concurrent ascites detected with ultrasound. Carcinomatosis was found at necropsy. Ultrasound examination proved to be a sensitive, noninvasive modality useful in diagnosis and treatment of pleural effusion.  相似文献   

8.
Thoracic CT may be used in the workup of patients with pleural effusion. In humans, certain pleural features on CT aid in diagnosing an underlying cause for pleural effusion, whereas this is not well studied in veterinary medicine. This retrospective cross‐sectional analytical study assessed pleural and other intrathoracic abnormalities on CT in dogs and cats with pleural effusion and explored potential discriminatory features between effusion types. Eighty‐nine dogs and 32 cats with pleural cytology and/or histopathology were categorized into malignant pleural disease (15 dogs and 11 cats), pyothorax (34 dogs and 7 cats), chylothorax (20 dogs and 11 cats), transudative (11 dogs and 2 cats), and hemorrhagic effusion (9 dogs and 1 cat). Multivariable logistic regression analysis comparing malignancy to other effusions found that older patient age (dogs: odds ratio 1.28, P = 0.015; cats: odds ratio 1.53, P = 0.005), nodular diaphragmatic pleural thickening (dogs: odds ratio 7.64, P = 0.021; cats: odds ratio 13.67, P = 0.031), costal pleural masses (dogs: odds ratio 21.50, P = 0.018; cats: odds ratio 32.74, P = 0.019), and pulmonary masses (dogs: odds ratio 44.67, P = 0.002; cats: odds ratio 18.26, P = 0.077) were associated with malignancy. In dogs, any costal pleural abnormality (odds ratio 47.55, P = 0.002) and pulmonary masses (odds ratio 10.05, P = 0.004) were associated with malignancy/pyothorax, whereas any costal pleural abnormality (odds ratio 0.14, P = 0.006) and sternal lymphadenopathy (odds ratio 0.22, P = 0.040) were inversely associated with transudates. There were, however, many overlapping abnormalities between effusion types, so further diagnostic testing remains important for diagnosis.  相似文献   

9.
The purpose of this study was to describe the clinical, radiographic, and computed tomographic findings in dogs and cats with migrating intrathoracic grass awns. Thirty-five dogs and five cats with visual confirmation of a grass awn following surgery, endoscopy or necropsy, and histology were assessed. The medical records and all diagnostic imaging studies were reviewed retrospectively. Labrador Retrievers or English Pointers < 5 years of age, with a history of coughing and hyperthermia, were the most common presentations. Seventeen animals had an inflammatory leukogram of which 14 had a left shift or toxic neutrophils. Radiographs were performed in 38 animals and computed tomography (CT) in 14. Thoracic radiographs were characterized by focal pulmonary interstitial to alveolar opacities (n = 26) that occurred most commonly in the caudal (n = 19) or accessory lobes (n = 8). Additional findings included pneumothorax (n = 9), pleural effusion (n = 8), and pleural thickening (n = 7). Pulmonary opacities identified on radiographs correlated to areas of pneumonia and foreign body location. CT findings included focal interstitial to alveolar pulmonary opacities (n = 12) most commonly in the right caudal lung lobe (n = 9), pleural thickening (n = 11), mildly enlarged intrathoracic lymph nodes (n = 10), soft tissue tracking (n = 7) with enhancing margins (n = 4), pneumothorax (n = 6), pleural effusion (n = 4), and foreign body visualization (n = 4). Histologic diagnoses included pulmonary and mediastinal granulomas or abscesses, bronchopneumonia, and pleuritis. Migrating intrathoracic grass awns should be considered as a differential diagnosis in coughing, febrile animals with focal interstitial to alveolar pulmonary opacities, pleural effusion, pleural thickening, and/or pneumothorax on radiographs or CT.  相似文献   

10.
A 14-year-old Quarter Horse gelding presented for a 2-week history of increased respiratory rate, fever and weight loss. The referring veterinarian performed an ultrasonographic examination on the farm and considered a differential diagnosis of pleuritis and pleuropneumonia. On presentation, transtracheal wash showed suppurative septic inflammation with bacteria within macrophages. Thoracic ultrasonography showed increased hypoechoic fluid in the pleural and peritoneal cavities. Cytologic analysis of pleural and peritoneal fluids revealed lymphorrhagic effusion with atypical lymphocytes, suggestive of a lymphatic flow obstruction or lymphoma. Treatment consisted of drainage of the pleural fluid, anti-inflammatory agents, fluid therapy and antimicrobial therapy. Continued fluid accumulation in the thoracic cavity, tachypnoea, lack of response to pain medication and progressive lethargy resulted in the horse being subjected to euthanasia. At necropsy, bicavitary effusion was confirmed and histopathological diagnosis of multicentric lymphoma was made. Horses presenting with pleural effusion should also be evaluated for peritoneal effusion, as bicavitary effusion may indicate noninflammatory conditions such as neoplasia.  相似文献   

11.
Pleural space masses and nodules are rarely described on computed tomography (CT) in veterinary medicine and have only been described in patients with neoplasia. Our purpose was to describe the CT findings and diagnoses in seven patients with pleural masses and nodules. Two patients had broad-based, plaque-like pleural masses, both of which were due to neoplasia (primary pleural carcinoma, metastatic thymoma). Two patients had well-defined pleural nodules and nodular pleural thickening, one of which had mesothelial hypertrophy, and another of which had metastatic hemangiosarcoma. Three patients had ill-defined pleural nodules to nodular pleural thickening, one of which had metastatic pulmonary carcinoma, while the other two had bacterial infection with mesothelial proliferation (n = 2), fibrinous pleuritis (n = 1), and severe mediastinal pleuritis/mediastinitis (n = 2). Five of the seven patients had focal, multifocal or diffuse smooth, and/or irregular pleural thickening. Five of seven patients had pleural effusion, and postcontrast CT was useful in several patients for delineating the pleural lesions from the effusion. All patients except one had additional lesions identified on CT besides those in the pleural space. CT is useful in identifying and characterizing pleural space lesions and could be used to guide further diagnostic procedures such as thoracoscopy or exploratory thoracotomy. Both neoplastic and nonneoplastic diseases should be considered in the differential diagnoses for pleural space masses and nodules found on CT.  相似文献   

12.
An ultrasound examination of the thorax of three horses which were performing poorly or had mild signs of colic showed that they had a cranial mediastinal mass and a pleural effusion. A cytological examination of the pleural fluid showed that it did not contain neoplastic cells. A histological examination of an ultrasound-guided core biopsy of the cranial mediastinal mass showed that in each of the three horses it was a lymphosarcoma.  相似文献   

13.
The radiographic findings in ten dogs with thoracic actinomycosis are presented. Radiographic findins varied, but pleural effusion, pulmonary infiltrates and mediastinal masses were most commonly found. Rib involvement, commonly accompanying actinomycosis in man, was present in only one dog. The differential diagnosis of actinomycosis includes many disease entities, but based on the radiographic signs it may be possible to narrow down the number of possiblities considerably. A combination of mediastinal or pulmonary masses, pleural effusion and encapsulated fluid is strongly indicative for actinomycosis. For confirmation a bacteriological examination is indicated.  相似文献   

14.
A 3-year-old spayed female Whippet was examined for cough and respiratory distress. Lung lobe torsion with pleural effusion was diagnosed, and lung lobectomy was performed. Pleural effusion recurred during the following 27 months; conventional bacteriologic cultures of pleural effusion did not result in bacterial growth. A second lung lobectomy, pleuroperitoneal shunt placement. and pericardectomy were subsequently performed. Mycobacterium kansasii was eventually isolated from pleural fluid and identified by polymerase chain reaction amplification and DNA sequencing. The dog was euthanatized before therapeutic response could be evaluated. To our knowledge, this is the first report of M. kansasii infection in a dog. Additionally, this is the first report of mycobacterial isolation from pleural fluid, and one of few reports of antemortem mycobacterial isolation from a body fluid, as opposed to identification in specimens during histologic examination. Routine bacteriologic culture methods are insufficient to isolate mycobacterial agents, and special methods are indicated in dogs with persistent pleural effusion.  相似文献   

15.
An 8‐year‐old, 6‐kg, male neutered Domestic Shorthair cat was presented to The Ohio State University Veterinary Medical Center (OSU‐VMC) for difficulty breathing. Physical examination and thoracic radiographs indicated pneumonia, a soft‐tissue mass in the left caudal lung lobe, and diffuse pleural effusion. The effusion was classified as modified transudate. Rare extracellular elongated (~5–7 μm × 1–2 μm) zoites with a central round to oval‐shaped purple to deep purple vesicular nucleus with coarsely stippled chromatin and light blue cytoplasm were seen on a peripheral blood smear. Serum IgG and IgM were positive for Sarcocystis sp. antibodies and negative for Toxoplasma gondii antibodies, suggesting that the infection was acute rather than a recrudescence of prior infection. This organism was most consistent with either Sarcocystis neurona or Sarcocystis dasypi based on DNA sequence analysis of PCR products using COC ssRNA, ITS‐1, snSAG2, and JNB25/JD396 primer sets. This is the first report to visualize by light microscopy circulating Sarcocystis sp. merozoites in the peripheral blood of a domestic cat. Therefore, Sarcocystis should be considered as a differential diagnosis in cats with suspected systemic protozoal infection.  相似文献   

16.
A 15 year-old grey Thoroughbred gelding presented for investigation of chronic weight loss and recent onset of respiratory difficulty. Clinical examination confirmed tachypnoea with increased respiratory effort. Thoracic ultrasound examination detected pleural effusion. The dyspnoea was related to the large volume of pleural effusion and, following post-mortem examination, to the presence of a large mediastinal mass. Multiple pigmented masses, likely melanomas, were detected peri-anally. Thoracic radiography, cytological examination of the pleural fluid and a fine needle aspirate of a thoracic mass led to a presumptive diagnosis of malignant melanoma and this was confirmed at post mortem examination. Further metastatic spread to the central nervous system and right guttural pouch was also identified. In conclusion this case manifests the potential malignant behaviour of equine melanomas, and a review of proposed therapies for melanoma treatment highlights the therapeutic options and current areas of research.  相似文献   

17.
A 3‐week‐old Pony of the Americas foal presented with a history of respiratory distress presumed to result from Actinobacillus equuli pleuropneumonia and septic arthritis. Failure of transfer of passive colostral immunity was suspected, but not confirmed, based on a history of the foal being separated from its dam shortly after parturition. Transient improvement was noted following thoracocentesis and removal of approximately 600 ml of pleural fluid but progressive clinical signs of congestive heart failure developed. Fibrinous pericarditis with evidence of cardiac tamponade was subsequently diagnosed via thoracic ultrasonography. Early clinical signs of cardiogenic shock were identified and fibrinopurulent exudate removed through a catheter placed with ultrasound guidance into the pericardium. The foal experienced cardiorespiratory arrest during the procedure and died despite resuscitative efforts. Post mortem examination identified extensive hypertrophy of the pericardium, septic arthritis, mild pleural effusion and focal bronchopneumonia. This report details the clinical evaluation, haematology, treatment and post mortem pathology of a foal with Actinobacillus equuli associated fibrinous pericarditis, as well as a brief review of cardiac tamponade.  相似文献   

18.
: A domestic-longhair cat presented due to lethargy, dyspnoea and hypersalivation. Radiographic examination revealed a bilateral pleural effusion, which was diagnosed as pyothorax based on cytological examination. Ultrasonographic examination revealed extensive loculations within the thoracic cavity. Exploratory sternotomy, under general anaesthesia, allowed the removal of approximately 100 ml of purulent fluid and debridement of a partially walled-off abscess and necrotic material from the pleural cavity. Postoperative positive-pressure ventilation was required due to severe respiratory depression. Intensive postoperative care, including intensive continuous monitoring, thoracostomy tube drainage and lavage of the pleural cavity and oesophagostomy tube feeding, was performed. Complete resolution of clinical signs had occurred by 15 days postoperatively. Clinical or radiographic abnormalities were not detected at a follow-up examination one year after surgery.  相似文献   

19.
Eighty-two cases of feline pleural effusion were identified and reviewed to assess the type of fluid, underlying disease process, predisposing conditions, historical and physical examination findings, laboratory and cytology data, response to treatment and outcome. Pertinent findings included a high occurrence of pleural effusion with mediastinal lymphoma (and other types of intrathoracic neoplasia), pyothorax, cardiomyopathy and feline infectious peritonitis virus infection. Sixteen cases, eight with chylous effusion, had no underlying disease identified. Cats with pyothorax and effusion secondary to trauma had the best prognosis for complete recovery. Otherwise, the outcome was variable and the prognosis was guarded to poor.  相似文献   

20.
Forty‐seven patients with a known history of thoracic trauma or clinical suspicion of pneumothorax were selected for thoracic imaging. The patient population was composed of 42 dogs and five cats. Standard vertical beam (VB) left and right lateral and ventrodorsal/dorsoventral (VD/DV) projections were obtained for each patient, and at least one horizontal beam (HB) projection (VD projection made in lateral recumbency). A total of 240 images were reviewed. Subjective assessment for the presence and degree of pneumothorax and pleural effusion was made more confidently with HB projections. Pneumothorax was identified in at least one projection in 26 patients (26 dogs) and pleural effusion in 21 patients (19 dogs and two cats). Pneumothorax and pleural effusion were present concurrently in 17 dogs. Pneumothorax and pleural effusion were graded for each image as absent, mild, moderate, or severe. Right (P<0.001) and left (P<0.05) lateral HB VD projections and the standard VB left lateral projection (P<0.05) were significantly more likely to detect and grade pneumothorax severely than the VB VD/DV views. The right lateral HB projection had the highest rate of detection and gradation of severity for pneumothorax compared with other views. VD/DV projections had the lowest sensitivity for detection of the pneumothorax and gradation of severity for pneumothorax and pleural effusion. No significant difference in diagnosis (P=0.9149) and grade (P=0.7757) of pleural effusion were seen between views, although the left lateral HB had both the highest rate of detection and grade of severity.  相似文献   

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