IMAGING DIAGNOSIS—PULMONARY INTERSTITIAL EMPHYSEMA IN A DOG

In humans, pulmonary interstitial emphysema is most frequently seen in ventilated preterm newborns with severe lung disease; it is less frequently reported in adults. We report on a mature dog with pneumopathy that underwent computed tomography (CT) imaging to further characterize the lung disease. A bronchiolar pattern and lobar opacification were seen on the CT images. Moreover, gas was detected along the course of the pulmonary vessels, presumably in the interstitium, as seen in pulmonary interstitial emphysema in humans. Sever lung disease and/or hyperventilation during anesthesia could be a possible explanation of pulmonary interstitial emphysema in this dog.     

IMAGING DIAGNOSIS—PULMONARY ALVEOLAR PROTEINOSIS IN A DOG

A young dog was presented for cyanosis and right heart failure. Radiographic and CT characteristics included right heart/pulmonary artery enlargement, hepatomegaly, abdominal effusion, and severe, generalized air‐space filling. Focal increased opacities were present in the peripheral lung, as were multiple pulmonary blebs and bullae. Echocardiographic findings were consistent with cor pulmonale and pulmonary hypertension. Bronchoscopic findings were consistent with chronic inflammation. Pulmonary alveolar proteinosis (PAP) was confirmed at necropsy. Pulmonary alveolar proteinosis is an interstitial lung disease that results in accumulation of phospholipoproteinaceous material and should be included as a differential diagnosis for dogs with these clinical and imaging characteristics.     

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.     

IMAGING DIAGNOSIS—SPINAL EPIDURAL HEMANGIOSARCOMA IN A DOG

An 8‐year‐old, male Boxer was examined for an acute onset of ambulatory paraparesis. Neurologic examination was consistent with a T3‐L3 myelopathy. Myelography revealed an extradural spinal cord compression in the region of the T10‐T13 vertebrae. On magnetic resonance (MR) imaging, a well‐defined epidural mass lesion was detected. The mass was mildly hyperintense on T1‐weighted, hyperintense on T2‐weighted and STIR images compared to normal spinal cord and enhanced strongly and homogenously. Postmortem examination confirmed a primary epidural hemangiosarcoma. Findings indicated that the MRI characteristics of spinal epidural hemangiosarcoma may mimic other lesions including meningioma and epidural hemorrhages/hematomas of non‐neoplastic etiology.     

IMAGING DIAGNOSIS—COMPUTED TOMOGRAPHIC,SURGICAL, AND HISTOPATHOLOGIC CHARACTERISTICS OF AN INFILTRATIVE ANGIOLIPOMA IN A DOG

A 6‐year‐old female spayed Shetland Sheepdog presented for evaluation of a subcutaneous mass over the right prescapular region. The mass had been cytologically diagnosed as a lipoma by the referring veterinarian 20 months prior, but had grown significantly and was very firm. CT scan of the mass was suggestive of neoplasia; however, the tissue of origin could not be determined. Histopathologic evaluation diagnosed infiltrative angiolipoma, and marginal resection of the tumor was performed. Infiltrative angiolipomas are benign but locally aggressive neoplasms uncommonly reported in veterinary medicine. This report correlates the clinical, CT, and histopathologic characteristics of an infiltrative angiolipoma.     

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–SCLEROSING ENCAPSULATING PERITONITIS IN A DOG

An approximately 5‐month‐old American Staffordshire terrier was presented with a history of recurrent peritoneal effusion. Abdominal radiographs and ultrasound showed a loculated effusion in the ventral abdomen with dorsal displacement of abdominal organs, hepatomegaly and rounding of liver and splenic margins. Computed tomography demonstrated centrally located gastrointestinal segments surrounded by a thin soft tissue band and a thickened peritoneal lining. At necropsy a fibrous membrane continuous with liver and splenic capsules encapsulated all abdominal organs. Microscopically the abdominal wall and fibrous capsule consisted of an irregular thick layer of hypocellular connective tissue. The final diagnosis was sclerosing encapsulating peritonitis.     

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—COMPUTED TOMOGRAPHY FINDINGS IN A DOG WITH SPONTANEOUS TRANSMURAL MIGRATION OF A TEXTILOMA INTO THE CECUM

A 3‐year‐old spayed female dog was presented with 3‐month history of severe bilateral uveitis subsequent to previous ovariohysterectomy. Physical examination revealed moderate abdominal pain. Computed tomography showed a nonobstructive heterogeneous mass‐like lesion with a speckled gas pattern (spongiform pattern) within the cecum. Exploratory laparotomy revealed a surgical swab in the lumen of the cecum with severe adhesions. Histopathological examination demonstrated a chronic inflammatory pyogranulomatous reaction to the retained swab embedded within the intestinal wall, consistent with transmural migration of the swab from the peritoneal cavity into the cecum.     

IMAGING DIAGNOSIS—SPINAL CORD CHONDROSARCOMA ASSOCIATED WITH SPIROCERCOSIS IN A DOG

A 7‐year‐old neutered female Boerboel cross was examined for progressive left pelvic limb lameness. There was no left patellar reflex but the remaining pelvic limb reflexes were hyperreflexic. Radiographically, there was a poorly mineralized opacity occupying the intervertebral foramen at L4–L5. On computed tomography images there was a hyperattenuating intramedullary lesion at L4–L5 that continued caudally, lateralized to the left and became extramedullary, terminating at L5–L6. In addition, well marginated, hyperattenuating lesions were noted at two muscular sites. The dog underwent euthanasia and a caudal esophageal mass was found at post mortem examination. The tumors in the spinal cord, the esophagus, and the skeletal muscles were diagnosed histologically as low‐grade chondrosarcoma undergoing endochondral ossification. Spirocerca lupi‐induced esophageal chondrosarcoma was believed to be the primary site from which the other, presumably metastatic, lesions originated.     

IMAGING DIAGNOSIS—USE OF MULTIPHASIC CONTRAST‐ENHANCED COMPUTED TOMOGRAPHY FOR DIAGNOSIS OF MESENTERIC VOLVULUS IN A DOG

A 4‐year‐old German shorthaired pointer presented with collapse and hematochezia. Radiographs showed gas and fluid‐distended small intestines and loss of serosal detail. Ultrasound examination showed hypomotile, fluid‐distended small intestines, and thrombosed jejunal veins. Multiphasic contrast‐enhanced computed tomography was performed and showed a CT “whirl sign,” an important but nonspecific sign of intestinal volvulus in human patients. At surgery, the majority of the small intestine was entangled in the volvulus and showed black discoloration. The patient was euthanized. Postmortem evaluation yielded a diagnosis of jejunoileal mesenteric volvulus secondary to a congenital omphalomesenteric duct remnant.     

IMAGING DIAGNOSIS—CT MYELOGRAPHY IN A DOG WITH INTRAMEDULLARY INTERVERTEBRAL DISC HERNIATION

A 5‐year‐old Chihuahua was examined for peracute pain and paraparesis. Neuroanatomic localization was consistent with a symmetric T3‐L3 myelopathy. Computed tomography (CT) of the T9‐L5 vertebrae was normal. Myelography disclosed attenuation of the subarachnoid space from T11 to L1, consistent with spinal cord swelling. CT following the myelogram disclosed a focal area of intramedullary iodinated contrast medium at T13‐L1. At surgery, intervertebral disc material was removed from the spinal cord. Based on the findings in this patient, intramedullary disc herniation should be considered a cause for focal intramedullary contrast medium accumulation.     

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—HYPEROSTOSIS ASSOCIATED WITH MENINGIOMA IN A DOG

A 5-year-old neutered male Beagle mix dog had a 5-day history of generalized tonic-clonic seizures. Before the seizures, the dog had a 1-2-month history of progressive right hemiparesis. In computed tomography images, a presumed extraaxial mass with hyperostosis and destruction of the skull covering the mass were identified. Surgical excision was performed and the histopathologic diagnosis was meningioma. Hyperostosis is frequently associated with feline meningioma, but this report documents that hyperostosis may also occur secondary to meningioma in the dog.     

IMAGING DIAGNOSIS—CELIACOMESENTERIC TRUNK AND PORTAL VEIN HYPOPLASIA IN A PIT BULL TERRIER

The computed tomography (CT) imaging findings of a celiacomesenteric trunk (CMT) in a 1‐year‐old dog with primary hypoplasia of the portal vein (PHPV) are described. Computed tomography angiography revealed acquired porto‐systemic shunts secondary to portal hypertension and a common origin of the celiac and cranial mesenteric arteries. The imaging findings and the association of a CMT with other vascular diseases have never been reported in dogs. The recognition of this rare arterial anomaly should prompt to investigate possible concurrent vascular diseases and may influence the planning of abdominal surgeries.     

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—MAGNETIC RESONANCE IMAGING FINDINGS OF AN INTRACRANIAL EPIDURAL TUBERCULOMA IN A DOG

Magnetic resonance (MR) imaging is highly sensitive for detecting tuberculomas in human patients but the specificity of the MR imaging features is low. Misdiagnosis with intracranial neoplasia is common, especially with dural‐based lesions or lesions located in the epidural space. We describe the MR imaging characteristics of an intracranial epidural tuberculoma caused by Mycobacterium tuberculosis infection in a dog. The intracranial mass and skull flat bone lysis and erosion are similar to those described in human caseating tuberculomas and can mimic intracranial neoplastic disease.     

IMAGING DIAGNOSIS—CONCENTRIC PERIRADICULAR LIPOMA CAUSING LUMBAR NERVE ROOT COMPRESSION IN A DOG

An 11‐year‐old, male neutered Jack Russell Terrier was presented with a nerve root signature of the right pelvic limb. Magnetic resonance imaging revealed a well demarcated, ovoid, extramedullary mass at the level of the L7 vertebral body. This showed, compared to normal spinal cord, hyperintense signal on T1‐ and T2‐weighted images, which was suppressed on gradient echo short tau inversion recovery (GE‐STIR) images. Additionally, the mass was characterized by a fat density on computed tomography images. Histopathology of the surgically excised mass was consistent with concentric periradicular lipoma, which has not been described in domestic animals yet.     

IMAGING DIAGNOSIS—MULTIMODALITY FINDINGS IN AN ADULT DOG WITH PRIMARY SARCOMA OF THE PULMONARY ARTERY AND MYOCARDIAL METASTASES

Intravascular pulmonary artery sarcomas in combination with myocardial metastasis are rare in dogs. We describe the radiographic, echocardiographic, and electrocardiographic‐gated (ECG‐gated) computed tomographic angiography (CTA) findings in a dog with pulmonary artery sarcoma. All imaging studies demonstrated severe main pulmonary artery enlargement. Echocardiography and ECG‐gated CTA revealed a mass occluding the lumen of the right pulmonary artery. In addition, CTA revealed focal left ventricular myocardial contrast enhancement and parenchymal lung changes. Postmortem examination confirmed the presence of a large thrombus associated with arteriosclerosis and an intravascular sarcoma in the right pulmonary artery with metastases to the myocardium, lungs and brain.     

IMAGING DIAGNOSIS—MRI CHARACTERISTICS OF A FOURTH VENTRICULAR CHOLESTEROL GRANULOMA IN A DOG

A 2‐year‐old male American Bulldog experienced paroxysmal staggering, altered consciousness, and hyperesthesia. Magnetic resonance (MR) imaging enabled recognition of a fourth ventricular mass causing compression of the cerebellum and brainstem and obstructive hydrocephalus. The mass was uniformly T2‐hyperintense and predominantly T1‐hypointense. A fluid line was evident on the fluid‐attenuated inversion recovery images. A thin rim of contrast enhancement was noted. Histopathologic diagnosis was a cholesterol granuloma. We were unable to identify any other reports of a cholesterol granuloma residing in the fourth ventricle of a dog. This case report documents the clinical, diagnostic imaging, and histopathologic findings of a canine intracranial cholesterol granuloma. © 2012 Veterinary Radiology & Ultrasound.