IMAGING DIAGNOSIS—MEDULLARY TIBIAL INFARCTION IN A HORSE

An Andalusian Stallion with left hind limb lameness had a radiolucent lesion in the medullary cavity of distal tibial metaphysis. After euthanasia for other disease, the tibia was examined with magnetic resonance (MR). The MR imaging sequences were characterized by a double line sign, although showing quite different lesion area intensities. Histologically, the lesion was compatible with medullary infarction being characterized by normal spongy bone, areas of abundant fibrous tissue and numerous necrotic adipocytes in various stages of destruction.     

IMAGING DIAGNOSIS—MUSCULAR HYPERTROPHY OF THE SMALL INTESTINE AND PSEUDODIVERTICULA IN A HORSE

A 14‐year‐old Thoroughbred gelding was presented for chronic colic and weight loss. Transcutaneous and transrectal abdominal ultrasonography revealed distended, thickened small intestine with primary thickening of the muscularis and a focally more thickened loop with an echoic structure crossing the wall from the mucosa to the serosa. Visualization of diffuse thickening of the muscularis (muscular hypertrophy of the small intestine) and a focal lesion (pseudodiverticulum) helped clinicians make informed decisions. This case illustrates the importance of transabdominal and transrectal ultrasonography in horses with chronic colic and the relevance of considering the abnormalities in layering pattern of the intestinal wall.     

IMAGING DIAGNOSIS—HYPOGLYCEMIA ASSOCIATED WITH CHOLANGIOCARCINOMA AND PERITONEAL CARCINOMATOSIS IN A HORSE

An 8‐year‐old Thoroughbred mare presented for decreased appetite, ataxia, and weakness. Abdominal ultrasound revealed a large volume of anechoic fluid along with multiple masses involving the spleen, liver, and diaphragm. Pleural fluid was identified via ultrasonography and thoracic radiography. Thoracic radiographs also identified pulmonary interstitial nodules, an undulant dorsal diaphragmatic margin and enlargement of tracheobronchial lymph nodes. Clinical signs of weakness and mild seizures were concurrent with hypoglycemic episodes. The final diagnosis was cholangiocarcinoma with extensive metastasis. Clinical signs of weakness, ataxia, and seizures were attributed to a paraneoplastic syndrome of tumor‐associated hypoglycemia that has been infrequently reported in horses.     

IMAGING DIAGNOSIS—MAGNETIC RESONANCE IMAGING OF A NEURONAL HETEROTOPIA IN THE BRAIN OF A CAT

A domestic shorthair kitten was presented for evaluation and further treatment of seizures. Magnetic resonance imaging of the brain revealed a large multilobulated mass in the third ventricle extending into the right lateral ventricle with secondary obstructive hydrocephalus. The mass was homogeneously isointense to gray matter on T2W, T2‐FLAIR, T2^*W, T1W, and ADC images, and hyperintense on DW‐EPI. There was no appreciable contrast enhancement. Seizures were managed medically and with subsequent ventriculoperitoneal shunt placement. Clinical status later deteriorated and the cat was euthanized. Histopathology confirmed that the mass was the result of neuronal heterotopia. To the authors’ knowledge this is the first report of neuronal heterotopia in a cat.     

IMAGING DIAGNOSIS—ULTRASONOGRAPHIC DIAGNOSIS OF DIPLOMYELIA IN A CALF

We describe the ultrasonographic diagnosis of diplomyelia in a 40‐day‐old calf. The acoustic window was the lumbosacral junction, which, in cattle, corresponds to the L6–S1 intervertebral space and enables the evaluation of approximately 1 cm of the length of the spinal cord. Despite this limited length, this acoustic window yields good anatomic details and can be helpful in assessing anomalies of the caudal aspect of the spinal cord.     

IMAGING DIAGNOSIS—GASTRIC PNEUMATOSIS IN A CAT

Gastrointestinal foreign bodies were removed surgically from a 9‐year‐old Siamese cat. Two days later the cat became lethargic and started regurgitating. A degenerative leukocytosis and drop in packed cell volume were present. Gastric wall thickening with intramural gastric air was detected radiographically and sonographically. Gastric ulceration with a focal necrotic area was seen endoscopically. At surgery, the stomach wall was emphysematous. Clinical signs resolved following partial gastrectomy and medical management. Intramural gastric air with declining clinical course was a significant impetus to return to surgery.     

IMAGING DIAGNOSIS—IMAGING AND HISTOPATHOLOGIC CHARACTERISTICS OF A VERTEBRAL HAMARTOMA IN A CAT

A 9‐month‐old domestic shorthair cat had progressive ambulatory paraparesis, proprioceptive ataxia, and thoracolumbar hyperesthesia. An extradural mass affecting the left pedicle and lamina of the second lumbar vertebra (L2) causing marked spinal cord impingement was identified in magnetic resonance (MR) images. The mass was predominantly calcified in computed tomographic (CT) images. A hemilaminectomy was performed to resect the mass. Clinical signs were greatly improved at 12‐month follow‐up. The histopathologic diagnosis was vascular hamartoma. To our knowledge, this is the first report describing the MR characteristics of a vascular hamartoma associated with the vertebral column.     

IMAGING DIAGNOSIS—TRACHEOBRONCHIAL ZYGOMYCOSIS IN A CAT

Tracheobronchial zygomycosis is described in a cat with acute dyspnea. Zygomycetes are an uncommon opportunistic group of pathogens, and few examples have been described in feline patients. Radiographic, ultrasonographic, and computed tomography imaging allowed identification of tracheobronchial masses, with intraluminal and peribronchial involvement. Surgical removal was impossible and antifungal chemotherapy was ineffective. Feline zygomycosis is a serious condition that should be considered when tracheobronchial masses are identified.     

IMAGING DIAGNOSIS—ENDOMETRIAL MINERALIZATION IN A DOG

A 9‐year‐old intact female mixed breed dog was presented for mammary gland tumor surgery, and preoperative radiographs showed a tubular soft tissue opacity mass with multifocal mineralization in the caudoventral abdominal cavity. Subsequent ultrasonography demonstrated uterine dilation with echogenic fluid and endometrial acoustic shadowing consistent with mineralization. Resection of mammary gland tumors and ovariohysterectomy were performed. Pyometra was diagnosed on cytologic examination of uterine fluid. Histopathology of the uterine tissue confirmed a diagnosis of cystic endometrial hyperplasia with uterine mineralization.     

IMAGING DIAGNOSIS—MAGNETIC RESONANCE IMAGING FEATURES OF A CEREBRAL HEMANGIOBLASTOMA IN A DOG

The magnetic resonance (MR) imaging features of a cerebral hemangioblastoma in a 9‐year‐old dog are described. Imaging revealed a well‐defined contrast‐enhancing lesion of the rostral forebrain that appeared extraparenchymal. Histopathology of the excised mass showed clusters of small blood vessels interspersed with interstitial cells staining positive for neuronal specific enolase, features consistent with a cerebral hemangioblastoma; the mass also appeared intraparenchymal after further immunohistochemistry study. This neoplasm should be considered a rare differential diagnosis for intracranial masses in dogs.     

IMAGING DIAGNOSIS—MAGNETIC RESONANCE IMAGING FEATURES OF METASTATIC CEREBRAL LYMPHOMA IN A DOG

We describe histopathologically confirmed intracranial metastasis of cutaneous lymphoma. In magnetic resonance (MR) images there was a heterogeneous, contrast‐enhancing, extraaxial mass in the right parietal and piriform lobes at the level of the optic chiasm. Our MR imaging findings are consistent with reports in humans in that lymphoma masses have indistinct borders that are iso‐ to hyperintense relative to adjacent gray matter on T2‐weighted images. Our report varies from findings in humans in that the mass was extraaxial, whereas masses reported in humans are intraaxial. Contrast enhancement can be heterogeneous, as in our report, or homogeneous.     

IMAGING DIAGNOSIS—A LUMINAL LAMINATED DEBRIS BALL IN THE URINARY BLADDER OF A DOG

A 5‐year‐old dog presented with pollakiuria and urinary incontinence. Abdominal radiographs revealed an oval, multilayered structure with soft tissue opacity and gas lucency in the urinary bladder. Ultrasonography showed an oval luminal structure with hyper‐ and hypoechoic layers and internal reverberation artifacts. Following cystotomy, the hemisected plane showed a layered, pale whitish matrix with a gas layer around the core. Histopathological examination showed no evidence of cells, bacteria, or fungi. The core and laminae comprised fibrinous and mineral debris. A final diagnosis of a freely floating, gas‐filled laminated debris ball was made.     

IMAGING DIAGNOSIS—THROMBOSED ORBITAL VARIX IN A DOG

A 9‐week‐old female Rhodesian Ridgeback presented with exophthalmos following minor blunt trauma to the left orbital area. Ocular ultrasound showed an extraconal retrobulbar mass ventromedial to the left globe. Magnetic resonance (MR) imaging demonstrated a thrombosed orbital vascular malformation without intracranial extension. Doppler ultrasound features of nonpulsatile slow flow were consistent with an orbital varix. Contrast‐enhanced dynamic time‐resolved and high‐resolution MR angiography demonstrated the varix arose from the anastomotic branch of the dorsal and ventral external ophthalmic veins. Conservative management led to a positive outcome defined as a visual eye and nearly normal cosmetic appearance at 8‐month follow‐up.     

IMAGING DIAGNOSIS—INTRACRANIAL CRYPTOCOCCAL MASS IN A CAT

A 4‐year‐old neutered female domestic shorthair was evaluated for mentation changes and left prosencephalic signs. This imaging report describes the imaging findings for this patient. A diagnosis of a cryptococcal mass was made based on imaging and additional diagnostics. Complete resolution of the mass was demonstrated by follow‐up imaging. This report serves as a reminder that masses associated with cryptococcal infection should be included on the differential list for cats with intracranial masses. In addition, this report provides evidence that large intracranial cryptococcal masses may resolve with long‐term medical therapy.     

IMAGING DIAGNOSIS—CONGENITAL LOBAR EMPHYSEMA IN A DOG

A 14‐week‐old female West Highland White Terrier developed acute dyspnea. Radiographically there was an enlarged, hyperlucent caudal portion of the left cranial lung lobe and a diffuse, severe interstitial‐to‐alveolar pattern in the remaining lung lobes that was accentuated caudodorsally. Computed tomography confirmed the presence of the emphysematous lobe and further showed it to have focal lobar bronchial collapse. Lung lobe resection was performed, and the diagnosis was congenital lobar emphysema secondary to bronchial cartilage hypoplasia.     

IMAGING DIAGNOSIS—DISSEMINATED PERITONEAL LEIOMYOMATOSIS IN A DOG

A 17‐month‐old male Labrador retriever presented for evaluation of an abdominal mass felt during abdominal palpation. Multiple variably sized cystic masses were identified on sonographic and radiographic images. Exploratory laparotomy revealed multiple peritoneal masses that exhibited atypical contractions and lacked an identifiable organ of origin. Histology and immunohistochemistry of multiple surgically excised masses was consistent with benign tumors of smooth muscle origin (leiomyomas). The presence of multiple peritoneal leiomyomas in this dog is consistent with disseminated peritoneal leiomyomatosis. Two years after diagnosis and multiple surgical interventions, continual insidious enlargement of leiomyomas was identified on ultrasound and CT.     

IMAGING DIAGNOSIS—HETEROBILHARZIA AMERICANA INFECTION IN A DOG

An approximately three‐year‐old mixed breed female dog was evaluated for peritoneal effusion, anorexia, intermittent vomiting, and diarrhea. Radiographically, there was mineralization of the wall of small intestinal segments. Sonographic findings were consistent with multisystemic mineralization of liver, small intestinal wall, and pancreas. Multifocal granulomas containing schistosome eggs (Heterobilharzia americana) were identified histologically. The mineralization pattern described herein is an uncommon presentation of severe diffuse heterobilharziasis in a dog.