Test 3: 39 xray cont Flashcards
extrapleural mass/signs will have — on xrays
Broad-based mass on the chest wall
Convex shape
Lungs displaced medially
+/- Uneven distances between ribs
+/- Lysis of ribs
Most often neoplasia
which one pulmonary mass vs extrapleural sign
extrapleural sign:
Broad-based mass on the chest wall
Convex shape
Lungs displaced medially
+/- Uneven distances between ribs
+/- Lysis of ribs
Most often neoplasia
what is found in the area of the mediastinum
Heart
Aorta
Vena cava (Cd & Cr)
Trachea
Esophagus
Thymus
Lymph nodes
the cranial and caudal ventral mediastinal structures are found —
left side- pushed over by lungs
the caudal vena cava is on what side of the body
right
what is found in the cranioventral mediastinum
sternal lymph nodes
+/- thymus
what is found in the craniodorsal mediastinum
Great vessels
Trachea
Esophagus
Cranial mediastinal lymph nodes
thymus- in the cranioventral mediastinum
juvenile dogs and cats
sail sign
normal thickness of cranial mediastinum
dog- 2x midth of vertebral body
cat- 1x width of vertebral body
unless fat→ may be wider
mediastinal masses may appear — on xray
- Midline location
- Widening of the mediastinum on VD – may have round or lobular (“bumpy”) margins
- +/- Dorsal displacement of the trachea
- +/- Caudal displacement of the carina
- +/- Silhouetting with heart
wide mediastinum from obese cat
straight sides, no mass effect
mediastinal masses in cranioventral location DDx
- Sternal lymphadenopathy
- Thymus→ (ex. Thymoma)
- Abscess
- Mediastinal cyst (especially cats)
- Esophageal diverticulum
- Ectopic thyroid neoplasia
mediastinal masses in craniodorsal location DDx
- Cranial mediastinal lymphadenopathy
- Focal esophageal dilation (ex. Vascular ring anomaly)
- Neurogenic tumor
- Vertebral tumor
perihilar mediastinal mass DDx
- Tracheobronchial lymphadenopathy
- Heart base mass (like chemodectoma) (top of heart is the base)
- Ectopic thyroid neoplasm
mediastinal mass in caudodorsal DDx
- Esophageal mass (or foreign body)
- Hiatal hernia
- Spirocerca lupi-parasite- south USA
- Vertebral tumor
- Paraesophageal abscess
caudoventral mediastinal mass location ddx
- Diaphragmatic hernia
- Abscess
where is sternal lymph node on xray
usually dont see- are swollen in this xray- can drain into the abdomen
where are the tracheobronchial lymph nodes
Perihilar
Middle (Cd) tracheobronchial LN
Ventral displacement of carina
Bowing of mainstem bronchi (“bow-legged cowboy”)
Double opacity sign
Left / Right tracheobronchial LN
Dorsal displacement of cd trachea
+/- widening of mainstem bronchi angle on VD
large middle tracheobronchial lymph node will move the carina —
ventrally
will also bow the main stem bronchi (bow legged cowboy)
double opacity sign
which tracheobronchial lymph node will cause dorsal displacement of the caudal trachea
left or right
+/- cause widening of the mainstem bronchi angle on VD
what is this showing
left: enlargment of middle tracheobronchial Lymph node → ventral displacement of carina
right: left atrial enlargment → dorsal displacement of carina
both will show bowing of the mainstem bronchi on VD (cowboy) and double opacity sign
mediastinal lymph node enlargement
ventral to trachea
+/- dorsal tracheal displacement
wide/convex cranial mediastinum (not straight line)
where are the lymph nodes
mediastinal lymphadenopathy
middle tracheobronchial cause ventral deflection, L and R cause dorsal deflection
widening of mediastinum
where are lymphnodes in this pt with medistinal lymphadenopathy
what is happening?
ddx
cranial mediastinal mass- pushing everything
Thymus →Neoplasia (Thymoma, Lymphoma); [↓Hemorrhage]
Lymph node (sternal, cranial mediastinal)→ Neoplasia (Lymphoma)
Mediastinum / Adnexa →Neoplasia (Sarcoma, Carcinoma); Cyst; [↓ Abscess, Granuloma, Hemorrhage]
DDX
cat
cranioventral mediastinal mass
soft tissue opacity cranioventral to heart
widens cranioventral mediastinum
DDX:
thyoma
mediastinal cyst
lymphoma
left sided- thymus
dog 11 YP lab with lethargy
DDX
heart base mass (perihilar region of mediastinum) → chemodectoma
soft tissue opacity at heart base, dorsally deviated trachea
wide/bulging cranial mediatstinum, trachea deviated to right
ddx
caudodorsal mediastinal mass
* Caudodorsal mass, cranial convex margin
* Focal widening (midline with bulge to right)
hiatal hernia
gas inside structure
increased contrast from —
pneumomediastinum- can see things you normal can’t see (ventral part of trachea)
