In collaboration with Dr. Adrien-Maxence Hespel from the University of Tennessee, we present the following radiology quiz. The goal of this case is to practice identifying radiographic findings and formulating a radiographic diagnosis based on a brief patient description. The final section provides additional information about the treatment.
13 year old female spayed cat. Anorexia. Peridontal disease.
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Orthogonal radiographs of the thorax are available for interpretation.
Within the cranial mediastinum, there is an ovoid, homogeneously soft tissue opaque structure which measures approximately 5.0 cm in length and extends from the second intercostal space to the fifth intercostal space along the left aspect of the cardiac silhouette. The cardiac silhouette and pulmonary vessels are normal.
The pulmonary parenchyma is normal.
The pleural space is normal.
There is mild, periarticular new bone formation at both glenohumeral joints. There is mild, multi-focal, incidental spondylosis deformans.
Within the included portion of the abdomen, the liver is mildly enlarged extending beyond the costal arch.
The ovoid soft tissue opaque structure within the cranial mediastinum may represent a malignant process (such as a thymoma) or a branchial cyst. The planned thoracic ultrasound may provide further information.
– Mild hepatomegaly is non-specific, but does raise concern for hepatic lipidosis given the reported hyporexia and anorexia. Malignancy (such as infiltrative neoplasia) cannot be excluded.
– Mild, bilateral glenohumeral degenerative joint disease.
On the annotated image the cardiac margin remains visible when superimposed with the caudal structure. This indicates that those two are not of the same opacity. Furthermore the caudal structure is slightly more radiolucent compared to the cardiac outline.
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