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Radiology Journal Club > Misc: lymph nodes, reproductive > Flashcards

Misc: lymph nodes, reproductive Flashcards

1
Q

Approximately how many cats, presenting for radio-iodide treatment for hyperthyroidism had abnormalities seen on US? What did these abnormalities consist of? How many of these were considered malignant?

Abdominal US findings in 534 hyperthyroid cats. JVIM Pre-published

A

Approximately 36% of cats had lesions seen on US.
Hepatic lesions - 5% of all the cats (534 cats)
Renal changes: 23% (122)
GI abnormalities - 2.6% (18)
Malignant: 2.4% (13) - most commonly was GI lymphoma

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2
Q

What is a uterus masculinus?

US features of uterus masculinus in 6 dogs. VRU 56.1

A

vestigial embryological remnant of paramesonephric (mullerian) duct system in males

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3
Q

Why do uterus masculinus occur?

US features of uterus masculinus in 6 dogs. VRU 56.1

A

Testis produce Mullerian inhibiting substance (MIS) (antimullerian hormone) secreted by sertoli cells. Failure of normal regression has been due to absence of MIS or ineffective hormoanl signaling pathway

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4
Q

What was US appearance of uterus masculinus?

US features of uterus masculinus in 6 dogs. VRU 56.1

A

Tubular (fluid filled) or cylindrical (no fluid)
Seen at dorsal aspect of cranial pole of prostate.
Internal surface was smooth or mildly irregular
Isoechoic to wall of urinary bladder
Prostatomegaly (4/6 were intact)
Cryptorchidism (2/6)
No gross distention or extensive cystic enlargement of the uterus masculinus (incidental findings)

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5
Q

Were dogs in the study of US features of uterus masculinus in 6 dogs. VRU 56.1 suffering from urinary signs as previously reported?

A

No.
These dogs were not clinical for their uterus masculinus. These were all incidental findings
ALTHOUGH, 3/6 of them did have UTI, and 5/6 had prostatomegaly.

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6
Q

What are imaging characteristics of an angiolipoma?

Imaging diagnosis - CT surgical and histopathologic characteristics of an infiltrative angiolipoma in a dog VRU 56.3.

A

Minimally contrast enhancing (

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7
Q

What are differences between angiolipoma, lipomas and hemangiomas?

Imaging diagnosis - CT surgical and histopathologic characteristics of an infiltrative angiolipoma in a dog VRU 56.3.

A

All of these are benign tumors

Angiolipoma - lipomatous mass with a higher soft tissue content that may or may not be invasive into musculature and vasculature.

Hemangioma - arises from the musculature

Lipoma - fat attenuating

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8
Q

What type of patient are Bates bodies most likely to be seen in?

Nodular fat necrosis in the feline and canine abdomen. VRU 41.4

A

Obese feline patients

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9
Q

What is ultrasonographic appearance of fat necrosis?

Nodular fat necrosis in the feline and canine abdomen. VRU 41.4

A

Hyperechoic mass with distal acoustic shadowing

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10
Q

What are main reasons that fat necrosis is thought to be formed?

Nodular fat necrosis in the feline and canine abdomen. VRU 41.4

A

Pressure ischemia, irculatory deficits in small capillaries nourishing the fat.

Similar changes may be seen secondary to infection, allergies, immune-mediate ddisease, trauma, subcutaneous injection, pancreatitis, glucocorticoid therapy, vasculitis, malnutrition, enteropathies and idoipathic disease

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11
Q

What are typical CT characteristics of a simple lipoma vs an infiltrative lipoma?

CT imaging of infiltrative lipoma in 22 dogs VRU. 42.3

A

Simple lipoma - fat opacity with differentiation from musculature/other structures. Non contrast enhancing (or minimal)

Infiltrative lipoma - are generally well defined, but can have regions that are ill-defined due to interdigitation with musculature/fibrous material. Does not infiltrate bone.

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12
Q

What signalment has previously been more likely to develop infiltrative lipoma? What is ratio?

CT imaging of infiltrative lipoma in 22 dogs VRU. 42.3

A

Females > male - 4:1

In this study - was 1:1

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13
Q

What is local recurrence rate of infiltrative lipomas after surgery?

A

36-50%

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14
Q

What is CT and radiographic protocol for mammary lymphography in cats?

CT and radiographic indirect lymphography for visualization of mammary lymphatic vessels and sentnel LN in normal cats. VRU 51.3

A

CT: 0.5mL iopamidol (300mg/mL) intramammary injection

Radiographs: 0.5mL ethiodized oil into subareolar tissue

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15
Q

How long after intramammary injection should CT be performed to evaluate the lymphatics and the sentinel LN in cats? Radiographs?

CT and radiographic indirect lymphography for visualization of mammary lymphatic vessels and sentnel LN in normal cats. VRU 51.3

A

CT: 1 minute
Radiographs: 7-15 minutes
**1st mammary gland took longer

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16
Q

How long after intramammary injection of contrast could adequate opacification of lymphatics and nodes be seen for CT in cats? Radiographs?

CT and radiographic indirect lymphography for visualization of mammary lymphatic vessels and sentnel LN in normal cats. VRU 51.3

A

CT: 5 minutes
Radiographs: 30-35minutes

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17
Q

After how long was contrast no longer visualized in the lymphatics associated with the mammary glands in CT in cats? Radiographs?

CT and radiographic indirect lymphography for visualization of mammary lymphatic vessels and sentnel LN in normal cats. VRU 51.3

A

CT: 30 minutes - contrast was still present in the sentinel node
Radiographs: 60 minutes

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18
Q

In the article: CT and radiographic indirect lymphography for visualization of mammary lymphatic vessels and sentnel LN in normal cats. VRU 51.3

Where were the mammary glands (1-4) most likely to drain to?

A

1&2 - accessory axillary

3 - inguinal (6/9), inguinal and axillary (2/9), axillary only (1/9)

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19
Q

In the article CT lymphography of the thoracic duct by mesenteric lymph node injection. Vet Surg 38. How was the examination performed?

A

1.5-2mL of Isovue (Iopamidol) non-ionic iodinated contrast into a mesenteric lymph node
Images were obtained 5 minutes later

20
Q

Ddx: for chylothorax

CT lymphography of the thoracic duct by mesenteric lymph node injection. Vet Surg 38

Comparison of rads and CT lymphangiography for ID of canine thoracic duct VRU 46.5

A 
ruptured thoracic duct
vena cava thrombosis
lymphatic wall erosion by a neoplasia or fungal disease
cardiomyopathy
heartworm
congenital defect
lung lobe torsion
constrictive pericarditis
idiopathic
21
Q

How do head and neck LN contribute to chylous effusion?

CT lymphography of the thoracic duct by mesenteric lymph node injection. Vet Surg 38

A

Most likely they don’t contribute.

The left superficial cervical LN connects with cranial thoracic lymphatic duct

22
Q

Approximately how many dogs (%) end up with post-ligation chylous or non-chylous effusion?

CT lymphography of the thoracic duct by mesenteric lymph node injection. Vet Surg 38

A

33%-57%

23
Q

Describe lymphatic drainage from the abdomen

Comparison of radiographic and CT lymphangiography for ID of canine thoracic duct VRU 46.5

A

Fluid within the abdomen drains to the lymphatics –> cisterna chyli which is reservoir ventral to L1-4. The thoracic duct travels along, dorsal to aorta and passes through hiatus. Drops into cranial mediastinum where empties into jugular/subclavian/brachiocephalic/azygous/cranial vena cava

24
Q

Where were the most ducts identified on radiographs or CT?

Comparison of radiographic and CT lymphangiography for ID of canine thoracic duct VRU 46.5

A

T9 (further cranial)

25
Q

Were there significant differences in number of ducts identified in radiographs vs CT?

Comparison of radiographic and CT lymphangiography for ID of canine thoracic duct VRU 46.5

A

Yes

T11 and L1 had significantly less ducts identified on radiographs than with CT

26
Q

How much contrast was injected into popliteal node in this study? How does this differ from others?

Comparative popliteal and mesenteric CT lymphangiography of the canine thoracic duct VRU 52.3

A

1mg/kg - more contrast - similar to amount given when injecting mesenteric lymph vessel directly

Other studies - 1.5-2, or 60mgI/kg

27
Q

Where was greatest # of thoracic duct branches located?

Comparative popliteal and mesenteric CT lymphangiography of the canine thoracic duct VRU 52.3

A

T9-L1, with the greatest number at T9

28
Q

Which had significantly greater # of opacified branches - mesenteric lymphatic injection or popliteal LN injection?

Comparative popliteal and mesenteric CT lymphangiography of the canine thoracic duct VRU 52.3

A

Mesenteric - but was not statistically significant.

Popliteal ID 93% of duct branches

29
Q

Which was significantly greater at detecting TD branches - helical or sequential CT?

Comparative popliteal and mesenteric CT lymphangiography of the canine thoracic duct VRU 52.3

A

Sequential. NOT significant - Helical ID 95% of branches

30
Q

In the article: Determination of optimal dosage and delay time for CT lyphography after percutaneous injection of iohexol into popliteal LN in dogs. J Vet Med Sci 71.1.

What was ideal concentration?

A

60mg I / kg

31
Q

According to the article: Determination of optimal dosage and delay time for CT lymphography after percutaneous injection of iohexol into popliteal LN in dogs. J Vet Med Sci 71.1, when should CT lymphography be performed?

A

> 2min

32
Q

What is US appearance of grass awns?

US features of grass awn migration in the dog. VRU 46.5

A

Linear, spindle-shaped shadow of variable length with 2-3 parallel reflecting interfaces corresponding to seeds and seed covers

Acoustic shadowing was detected in sagittal images

may have hypoechoic, accumulation of inflammatory fluid surrounding the grass awn

33
Q

What bone changes were seen in association with grass awns?

US features of grass awn migration in the dog. VRU 46.5

A

smooth periosteal reaction

34
Q

What was appearance of grass awns in vitro (in a water bath) when compared to in vivo (in the tissues)?

US features of grass awn migration in the dog. VRU 46.5

A

Similar appearance

Acoustic shadow, parallel interfaces, spindle shape

35
Q

What imaging characteristics may differentiate between non-parenchymal hemangiosarcoma and a soft tissue sarcoma?

CT features of canine non-parenchymal HSA VRU 55.4

A

Intense foci of contrast enhancement - due to vascular channels within the tumor

36
Q

What imaging characteristics did not differ between STS and HSA?

CT features of canine non-parenchymal HSA VRU 55.4

A

Size, shape, invasion into surrounding tissues, pattern of enhancement (heterogeneous), pre-contrast heterogeneous appearance

37
Q

What is the most common site of cryptorchidism in dogs vs cats?

Use of US to locate retained testes in dogs and cats VRU 53.5

A

Dogs - right sided inguinal, right sided abdominal

Cats - left and right sided inguinal

38
Q

How much more likely is neoplastic transformation of testicles to occur in cryptorchid dogs?

Use of US to locate retained testes in dogs and cats VRU 53.5

A

9.3-13.6x more frequeny

39
Q

What are the most common neoplasias seen in cryptorchid dogs?

Use of US to locate retained testes in dogs and cats VRU 53.5

A

sertoli cell tumor

seminoma

40
Q

What is PPV of US to detect a reatined testes?
What does this mean?
Use of US to locate retained testes in dogs and cats VRU 53.5

A

PPV = 100%

If a retained testes is found on US - 100% PPV to find in that same loctaion at surgery.

41
Q

What is sensitivity of finding intraabdominal or inguinal retained testes?

Use of US to locate retained testes in dogs and cats VRU 53.5

A

Intraabdominal - 96%

Inguinal - 100%

42
Q

What is hermaphroditism?

Male pseudohermaphroditism in dogs: 3 case reports. Veterinarni Medicina, 52.2

A

Both testicular and ovarian tissues are present in various combinations

IE: testis on one side, ovary on the other side, or an ovotestis

43
Q

What is pseudohermaphroditism?

Male pseudohermaphroditism in dogs: 3 case reports. Veterinarni Medicina, 52.2

A

Disagreement between phenotypic and gonadal sex

Gonads of one sex (of which they are classified as male or female), with secondary sex characteristics and external genitalia of the opposite sex.

Male: testis with mixed/female external genitalia
Females: ovaries, but phenotypically have masculine appearance

44
Q

What are 3 major events of sexual differentiation?

Male pseudohermaphroditism in dogs: 3 case reports. Veterinarni Medicina, 52.2

A

1) Chromosomal sex - with Y that carries an SRY gene that leads to testicle development. Lack of SRY –> ovarian differentiation

2 &3) Males have 2 hormones: Mullerian inhibiting factor and testosterone. Testosterone converted to active form by DHT. Absence of these hormones (MIF and DHT) leads to development of female development

45
Q

What is sex reversal?
What is it caused by?
What breed is sex reversal most commonly seen in?

Male pseudohermaphroditism in dogs: 3 case reports. Veterinarni Medicina, 52.2

A

Discordance between sex chromosome composition and gonadal and external phenotype.

Example - appears as a male pseudohermaphrodite (male organs, female characteristics), but has an XX genotype.

Caused by a sex reversal gene located on an autosome.

Most common in: American cocker spaniels

Radiology Journal Club (19 decks)

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