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Tran DTH, Donovan TA, Daverio H, Le Roux AB. CT features of rounded atelectasis in chronic inflammatory pleural effusions in cats and dogs. Vet Radiol Ultrasound 2023; 64:420-428. [PMID: 36751880 DOI: 10.1111/vru.13220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/07/2022] [Accepted: 01/02/2023] [Indexed: 02/09/2023] Open
Abstract
Rounded atelectasis is well described in human medicine as focal lung deformation and collapse secondary to inflammatory pleural effusions and pleuritis. Specific CT features (round to ovoid soft tissue pulmonary attenuations, creation of an acute angle with the adjoining visceral pleura, and the presence of perinodular comet tail signs) support the diagnosis of rounded atelectasis in humans so that further diagnostic workup is not necessary in defining the nodules. In this retrospective case series, we described the CT characteristics of rounded atelectasis in eight cats and three dogs diagnosed with restrictive pleuritis secondary to either a chylothorax or pyothorax. Thirty-six soft tissue attenuating pulmonary nodular lesions were identified on CT. Comet tail signs, consisting of bundles of bronchi and vessels coalescing into the pulmonary nodules, were associated with 92% of the nodules (33/36), and 92% of the nodules abutted and created an acute angle with the pleura (33/36). Other prevalent features included location in gravity-dependent regions of the lung lobes (33/36, 92%), blurred hilar margins with sharper pleural margins of the nodules (33/36, 92%), presence of air bronchograms (30/36, 83%), homogeneous contrast-enhancement (23/36, 64%), and volume loss of the affected lung lobe (22/36, 61%). Pulmonary malignant neoplasms were not found cytologically (6/11 patients) or histologically (5/11 patients). To avoid a misdiagnosis of neoplasia, veterinary radiologists should be aware of the CT features of rounded atelectasis and consider it as a differential for pulmonary nodular lesions in patients with concurrent inflammatory pleural effusion and pleuritis.
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Affiliation(s)
- Danielle T H Tran
- Department of Diagnostic Imaging, Schwarzman Animal Medical Center, New York, New York, USA
| | - Taryn A Donovan
- Department of Anatomic Pathology, Schwarzman Animal Medical Center, New York, New York, USA
| | - Heather Daverio
- Department of Anatomic Pathology, Schwarzman Animal Medical Center, New York, New York, USA
| | - Alexandre B Le Roux
- Department of Diagnostic Imaging, Schwarzman Animal Medical Center, New York, New York, USA
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Bianchi A, Collivignarelli F, Paolini A, Vignoli M, Niebauer GW, Dolce G, Canal S, De Bonis A, Rosto M, Del Signore F, Tamburro R. Thoracoscopic Assisted PleuralPort TM Application in Seven Dogs Affected by Chronic Pleural Effusion. Vet Sci 2023; 10:vetsci10050324. [PMID: 37235407 DOI: 10.3390/vetsci10050324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/24/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023] Open
Abstract
Chronic non-septic pleural effusion is a condition that frequently may occur because of lung or pleural neoplasia, or chylothorax refractory to surgical treatment, in dogs. Effusion management can be performed with multiple pleurocenteses or the application of chest drains. New modified vascular devices have been used for patients with chronic diseases; they offer the advantage of allowing home management and do not require hospitalization. Eight PleuralPortTM devices were applied in seven dogs during thoracoscopic exploration and biopsy procedures; five were affected by mesothelioma; one by lung metastases from a mammary carcinoma; and one by chronic chylothorax. The median time of surgical procedure was 51 min; one developed pneumothorax post-operatively that resolved within 12 h after repeated drainage; one device was obstructed after 45 days and was successfully managed by flushing. All patients were discharged after 24 h. The median duration of port insertion in cancer patients was 5 months and those dogs were euthanized because of tumor progression; in the dog with chylothorax, the device was removed after 1 year when the effusion had resolved.
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Affiliation(s)
- Amanda Bianchi
- Department of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | | | - Andrea Paolini
- Department of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | - Massimo Vignoli
- Department of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | - Gert W Niebauer
- Department of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | - Giulia Dolce
- Roma Sud Veterinary Clinic, Via Pilade Mazza, 00173 Roma, Italy
| | - Sara Canal
- Department of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | - Andrea De Bonis
- Department of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | - Martina Rosto
- Department of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | | | - Roberto Tamburro
- Department of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
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Fukuda S, Reetz JA, Hamamoto K, Griffin L, Schaffer PA. Diagnostic imaging and histopathologic features of rounded atelectasis in four cats and one dog: A descriptive case series study. Vet Radiol Ultrasound 2022. [PMID: 36529901 DOI: 10.1111/vru.13206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 12/23/2022] Open
Abstract
In humans, rounded atelectasis is defined as focal lung collapse that radiologically appears as a round mass-like lesion in the periphery of the lung. In general, human patients with rounded atelectasis have a history of pleural effusion and abnormal pleura and characteristic CT findings help to distinguish rounded atelectasis from pulmonary neoplasia without the need for invasive surgical biopsy. This retrospective multi-center case series describes rounded atelectasis in four cats and one dog. Chylothorax was seen in four patients and an eosinophilic and lymphoplasmacytic effusion was seen in one patient. All patients had solitary or multifocal subpleural pulmonary masses (26 masses total in 5 patients) with diffuse, multifocal, or focal visceral and parietal pleural thickening. All the masses but one were broad-based towards the visceral pleura. Masses were most common in the ventral or lateral aspect of the lungs. Indistinctness at the hilar aspect of the lesion was seen in all masses; a "comet tail" sign was seen in 14 of 26 masses. On postcontrast images, the lesions were homogeneously enhanced in 24 of 26 masses and heterogeneous in two of 26 masses. Other findings include ground glass opacities (n = 5), parenchymal bands (n = 4), mild to moderate lymphadenopathy (n = 4), and compensatory hyperinflation of the lung lobes not affected by atelectasis (n = 2). Histopathology of four cases revealed atelectasis with fixed pleural folds, chronic pleuritis, and mild to moderate pleural fibrosis. Awareness of rounded atelectasis in veterinary species will enable inclusion of a benign etiology into the differential diagnosis for subpleural masses in cases with pleural abnormalities.
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Affiliation(s)
- Shoko Fukuda
- Department of Radiology, Veterinary Specialists Emergency Center, Saitama, Japan
| | - Jennifer A Reetz
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - Kohei Hamamoto
- Department of Radiology, National Defense Medical College, Saitama, Japan
| | - Lynn Griffin
- Department of Environmental Health and Radiological Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Paula A Schaffer
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USA
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Sim JJ, Lau SF, Omar S, Watanabe M, Aslam MW. A Retrospective Study on Bacteriology, Clinicopathologic and Radiographic Features in 28 Cats Diagnosed with Pyothorax. Animals (Basel) 2021; 11:2286. [PMID: 34438744 PMCID: PMC8406089 DOI: 10.3390/ani11082286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 07/22/2021] [Accepted: 07/28/2021] [Indexed: 12/21/2022] Open
Abstract
This retrospective study aimed to determine the etiological, clinicopathological, and radiographic features and outcome of feline pyothorax cases. Medical records from twenty-eight cats with pyothorax aged from 4 months to 10 years (median 10 months) diagnosed between 2013 and 2020 were reviewed. Dyspnoea (75.0%), abnormal lung sounds (75.0%) and open-mouth breathing (64.3%) were the predominant respiratory signs. Leucocytosis (61.5%), particularly monocytosis (68.0%), and hyperglobulinaemia (65.4%) were among the most prominent findings in blood analysis. Bilateral pleural effusion was found in 67.9% of the thoracic radiographs. A total of 47.4% of the cytological samples revealed the presence of bacteria, while all had positive bacterial growth. Pasteurella multocida, E. coli, Streptococcus spp., and Staphylococcus spp. were the predominant aerobic bacteria isolated from pleural effusion samples. A chest tube was placed in 64.3% of the cats and 66.7% of cats with chest tubes survived. In total, 46.4% of cats with pyothorax recovered. Amoxicillin-clavulanate was the antimicrobial of choice against aerobic bacteria found in this study and should be given in combination with antimicrobials that cover anaerobic bacteria. Chest tube placement is crucial for treatment success. Cytological results and bacterial culture may not be consistent; thus, bacterial culture should be performed for every case.
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Affiliation(s)
- Juin Jia Sim
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, University Putra Malaysia, Serdang 43400, Malaysia; (M.W.); (M.W.A.)
| | - Seng Fong Lau
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, University Putra Malaysia, Serdang 43400, Malaysia; (M.W.); (M.W.A.)
- Laboratory of Cancer Research UPM-MAKNA (CANRES), Institute of Bioscience, University Putra Malaysia, Serdang 43400, Malaysia
| | - Sharina Omar
- Department of Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine, University Putra Malaysia, Serdang 43400, Malaysia;
| | - Malaika Watanabe
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, University Putra Malaysia, Serdang 43400, Malaysia; (M.W.); (M.W.A.)
| | - Muhammad Waseem Aslam
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, University Putra Malaysia, Serdang 43400, Malaysia; (M.W.); (M.W.A.)
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