February 2021 Imaging Case of the Month: An Indeterminate Solitary Nodule

No abstract available. Article truncated after first page. Clinical History: A 43 -year-old woman with no past medical history presented to the Emergency Room with complaints of right chest wall pain extending into the right upper quadrant. The patient was a non-smoker, denied any allergies, and was not taking any prescription medications. Physical examination showed the patient to be afebrile with normal heart and respiratory rates and blood pressure = 110/75 mmHg. Her room air oxygen saturation was 99%. The patient’s complete blood count and serum chemistries showed normal values. Her liver function testing and renal function testing parameters were also within normal limits. Which of the following represents an appropriate next step for the patient’s management? 1. Perform abdominal ultrasound 2. Perform chest radiography 3. Perform unenhanced chest CT 4. More than one of the above 5. None of the above …

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Hermafroditismo verdadeiro na espécie canina

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.85683 ◽

2017 ◽

Vol 45 ◽

pp. 5

Author(s):

Paula Priscila Correia Costa ◽

Cleyson Teófilo Braga Filho ◽

Luana Azevedo Freitas ◽

Maressa Holanda Dos Santos ◽

Leonardo Alves Rodrigues Cabral ◽

...

Keyword(s):

Complete Blood Count ◽

Body Condition Score ◽

External Genitalia ◽

Abdominal Ultrasound ◽

General Term ◽

Lower Quadrant ◽

True Hermaphrodite ◽

Genital Ambiguity ◽

The Right ◽

Umbilical Scar

Background: Hermaphroditism or intersex is a general term that includes various congenital anomalies of the genital system which is used to define animals with ambiguous sexual characteristics. It occurs in domestic animals, more commonly in pigs and goats, and rarely in horses, dogs, sheep, and cattle. The prevalence of hermaphroditism varies a lot among breeds and species and is higher in groups with a high degree of consanguinity. Therefore, the objective of this report is to describe a case of canine hermaphroditism in a dog with male phenotype, as well as the anatomical and hormonal findings, and classification of the hermaphroditism exhibited by the animal studied.Case: A 1-year-old, mongrel, 5 kg dog was referred to the UHV-UECE due to the presence of a slit on the lower quadrant of the abdomen, caudal to the umbilical scar. At examination, the animal exhibited normal rectal temperature, no alterations of palpable lymph nodes, and a satisfactory body condition score. The pubic area had 2 testicles, each one in a different scrotum, 1 to the right and 1 to the left of the slit. A prepuce with no apparent function was present cranially to the slit, closer to the umbilical scar. At the other extremity of the slit, on the pubic region, there was a flaccid structure similar to a penis (micropenis) with no penile bone and no function. The slit was open until the area ventral to the anus, where the urethra was detected. The animal exhibited a behavior of territory demarcation with urine typically seen in male dogs. Orchiectomy and slit correction surgery were performed. Pre-surgical exams included: complete blood count and hormonal doses of estradiol, testosterone, and progesterone. Abdominal ultrasound was performed to assess presence of sexual glands and gonads. The hormonal exam revealed: estradiol 56.39 pg/mL; testosterone 127.9 ng/mL; progesterone 0.892 ng/mL. A uterus was not detected on ultrasound examination. Ovaries were seen on their typical anatomical position; they were symmetrical and had normal sizes. There was a normal size prostate in the pelvic area, exhibiting normal texture and echogenicity. No other abnormalities were seen and the owner opted for no further surgical intervention.Discussion: Testosterone predominance explains the male behavior and appearance, demonstrating that the testis were prevalent over the ovaries. The occurrence of XX males has been reported. The genetic cause is the absence of the SRY chromosome, which has a fundamental role on activation of the SOX gene, which is responsible for sex determination. Clinically, a true hermaphrodite can exhibit different degrees of genital ambiguity; they can be diagnosed during puberty with the emergence of heterosexual characteristics, or as an adult, with infertility or gonadal neoplasia. True hermaphrodites are individuals with testicular and ovarian tissues, either combined in one gonad (ovotestis) or present as two separate gonads. The presence of ovaries and testicles can be confirmed by histology, which was not performed in this study. However, ultrasound findings (prostate and ovaries), and the presence of normal testis and external genitalia without a defined penis or vulva are in accordance with the description of a true hermaphrodite.

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Uterus unicornis and pregnancy in two feline littermates

Journal of Feline Medicine and Surgery Open Reports ◽

10.1177/2055116917743614 ◽

2017 ◽

Vol 3 (2) ◽

pp. 205511691774361

Author(s):

Wilson C Brookshire ◽

Jacob Shivley ◽

Kimberly Woodruff ◽

Jim Cooley

Keyword(s):

Renal Agenesis ◽

Case Series ◽

Abdominal Ultrasound ◽

Female Offspring ◽

Uterine Horn ◽

Normal Limits ◽

Histopathologic Diagnosis ◽

Underlying Causes ◽

The Right

Case series summary A queen, tom and four 1-year-old female offspring presented for routine neuter. Two of the littermates (cats 1 and 2) were diagnosed with a uterine abnormality during surgery. The left uterine horn of both cats appeared as a thin, solid, cord-like structure, whereas the right uterine horn of both cats appeared to have intermittent bulges consistent with pregnancy. The two other littermates, queen and tom were reproductively normal. The uteruses of the affected cats were nearly identical with a gross and histopathologic diagnosis of uterus unicornis with concurrent pregnancy. Ovaries were present, bilaterally. An oviduct was present only on the single normally developed and pregnant uterine horn in both cats. At a postoperative follow-up evaluation, abdominal ultrasound was performed on the two cats with uterine abnormalities. Cat 1 was ultrasonographically within normal limits. Cat 2 was diagnosed with ipsilateral renal agenesis on the same side as the absent uterine horn. Relevance and novel information The complexity of uterus unicornis and renal aplasia is demonstrated by this unique presentation of five related cats for ovariohysterectomy. This report raises questions regarding the genetic, environmental, hormonal or other underlying causes of this anatomic abnormality in cats that may spur additional research. This is the first publication describing uterus unicornis in gravid feline littermates, with one of the cats having ipsilateral renal agenesis. This is also the first publication to describe oviduct agenesis on the affected uterine horn in feline uterus unicornis.

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Gastrointestinal stromal tumor resulting in recurrent colic in a arabian horse gelding a report of case

Insights in Veterinary Science ◽

10.29328/journal.ivs.1001026 ◽

2020 ◽

Vol 4 (1) ◽

pp. 048-050

Author(s):

Briceño Abelardo Morales ◽

Oliva Harmon

Keyword(s):

Gastrointestinal Stromal Tumor ◽

Body Condition Score ◽

Vital Signs ◽

Abdominal Ultrasound ◽

Stromal Tumor ◽

Normal Limits ◽

Eosinophilic Cytoplasm ◽

Arabian Horse ◽

The Right ◽

Adjacent Segments

Background: A Grey 12-year-old Arabian endurance horse gelding was referred to the SHS Veterinary Center for anorexia, mild colic of 5 days duration, and melena of 1 day duration. The owner reported recurring colic, 12 episodes of mild colic in the previous year. Methods: On admission, vital signs were within normal limits and body condition score was estimated to be 3/9. Results: Packed cell volume (PCV) was 28% [reference range (RR): 31% to 47%] and plasma total protein was 58 g/L (RR: 60 to 80 g/L). Hematochezia was observed. Abdominal ultrasound examination detected no abnormalities. Over the next 12 h, the horse experienced hematochezia and several mild episodes of colic and death. A necropsy was performed. A mass arising from the right dorsal ascending colon near the base of the cecum and extending transmurally from the colonic mucosa into the mesocolon was a 8 cm × 5 cm × 8 cm firm, homogenous, tan mass. The portion of the mass that extended into the colonic lumen was pedunculated, with an ulcerated surface. The adjacent segments of colon were markedly reddened and edematous. Histologically, the mass was comprised of large interweaving sheets of small, spindle cells with ill-defined cell borders embedded in abundant myxomatous matrix. Tumor cells contained scant eosinophilic cytoplasm and oval to elongate nuclei with finely stippled chromatin and inconspicuous nucleoli. Mitotic figures were rare (1/10) high power fields. Tumor infiltrated between the muscularis interna and the muscularis externa at the myenteric plexi. Conclusion: Gross and histologic appearance, were consistent with a diagnosis of gastrointestinal stromal tumor.

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A case of periosteal proliferative polyarthritis in a cat

Journal of the Hellenic Veterinary Medical Society ◽

10.12681/jhvms.15153 ◽

2017 ◽

Vol 55 (1) ◽

pp. 46

Author(s):

M. KARAYANNOPOULOU (Μ. ΚΑΡΑΓΙΑΝΝΟΠΟΥΛΟΥ) ◽

Z. S. POLIZOPOULOU (Ζ.Σ. .ΠΟΛΥΖΟΠΟΥΛΟΥ) ◽

A. F. KOUTINAS (Α. Φ. ΚΟΥΤΙΝΑΣ) ◽

M. N. PATSIKAS (Μ.Ν. ΠΑΤΣΙΚΑΣ) ◽

G. KAZAKOS (Γ. ΚΑΖΑΚΟΣ) ◽

...

Keyword(s):

Elbow Joint ◽

Complete Blood Count ◽

Weight Bearing ◽

Serum Biochemistry ◽

Adverse Side Effect ◽

Left Elbow ◽

Normal Limits ◽

Thoracic Limb ◽

History Of ◽

The Right

In this paper a case of periosteal proliferative polyarthritis in an 11-year old, female Siamese cat, that was admitted to the Surgery Clinic of the Veterinary School, A.U.Th., with a 6-month history of non-weight bearing lameness of the left thoracic limb, is described. At physical examination, restricted range of motion of the left elbow joint, local swelling and pain were detected. In the radiological examination of the affected joint the main finding was a periarticular extensive and irregular periosteal new bone formation. The results of the complete blood count and routine serum biochemistry were within normal limits and the cat was serologically negative for FeLV and FIV. Synovial fluid examination showed a lymphoplasmacytic pleocytosis, while the bacterial culture was negative. Prednisolone given at an anti-inflammatory dose for two consecutive weeks resulted in a marked improvement of the clinical sings. However, two months after the end of the treatment lameness reappeared, but this time in the contralateral thoracic limb, due to the involvement of the same joint. Radiology revealed the same type of lesions in the right elbow joint, whereas the left became ankylosed. Again, prednisolone, given at an immunosuppressive dose for two weeks, did not improve but fairly the clinical condition of the animal and the radiological changes as well. For this reason azathioprine at the dose of 1 mg/kg BW, every 48 hours, was added to therapy that lasted for 5 months. Transient mild leukopenia, that resolved after decreasing the dose of azathioprine by 25%, was the only adverse side effect noticed. At the end of the treatment, regression of the radiographical lesions in both elbows enabled the cat to walk with a stilted gait, despite the development of joint ankylosis bilaterally. The disease was kept in remission during the 12-month follow up period.

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Diabetic Ketoacidosis Misdiagnosed and Managed as Typhoid Ileal Perforation in a Ghanaian Child: A Case Report

Journal of Health Science and Medical Research ◽

10.31584/jhsmr.2021825 ◽

2021 ◽

Author(s):

Emmanuel Ameyaw ◽

Alhassan Abdul-Mumin ◽

Abiboye Cheduko Yifieyeh ◽

Akua Afriyie Ocran ◽

Naana Ayiwa Wereko Brobbey

Keyword(s):

Blood Glucose ◽

Diabetic Ketoacidosis ◽

Complete Blood Count ◽

Bowel Perforation ◽

Abdominal Ultrasound ◽

Undiagnosed Diabetes ◽

Critically Ill Children ◽

Ileal Perforation ◽

Abdominal Organs ◽

The Right

We report on a 15-year-old Ghanaian boy, who presented to a district hospital with diabetic ketoacidosis (DKA) but was diagnosed wrongly as a small bowel perforation due to typhoid fever. He presented with weakness, poor feeding, vomiting, and severe abdominal pain. General examination revealed a lethargic, drowsy, and severely dehydrated patient. His abdomen was diffusely tender more in the right ileac fossa. Investigations including complete blood count, blood smear for malaria parasites, urinalysis, and abdominal ultrasound yielded unremarkable results. Hemoglobin level was 12.4 grams per decilitre. He was diagnosed as typhoid ileal perforation and laparotomy was done, but the bowels and all other intra-abdominal organs were found to be normal. A blood glucose test was done intraoperatively, and it found very high hyperglycaemia. This led to the suspicion of DKA, which was confirmed through urine dipstick testing for high urine ketones and a high glycated hemoglobin (HbA1C) test result. He was then treated for DKA, which resolved on the second day of admission, but the surgical wound healed after twelve days.Our account emphasizes the need for testing for blood glucose in critically ill children and adolescents with suspected severe infections or acute medical conditions that require admission or surgical intervention. This owes to the fact that the clinical features of undiagnosed diabetes, especially if it progresses to DKA, are similar to those of infections and disorders managed via surgical treatment, which are rather more common in Ghana and Africa.

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Infiltrative Cutaneous Hemangiolipoma in a Goat

Veterinary Medicine International ◽

10.1155/2013/942351 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4

Author(s):

Jessica R. Collier ◽

Stacey R. Byers ◽

Paula A. Schaffer ◽

Deanna R. Worley ◽

E. J. Ehrhart ◽

...

Keyword(s):

Complete Blood Count ◽

Cutaneous Lesion ◽

Surgical Excision ◽

Abdominal Ultrasound ◽

Final Diagnosis ◽

Treatment Method ◽

En Bloc ◽

Colorado State University ◽

Normal Limits ◽

First Case

An approximately 4-year-old castrated male, Saanen cross goat presented to the Colorado State University Veterinary Teaching Hospital for evaluation and removal of a 22 cm × 22 cm, dark red, thickened, and crusted cutaneous lesion along the left ventrolateral thorax. An initial incisional biopsy performed approximately 8 weeks earlier was suspicious for cutaneous hemangiosarcoma. Surgical excision was deemed to be the most appropriate treatment option for this goat. A complete physical exam, complete blood count, and chemistry profile were performed and results were within normal limits. Thoracic radiographs and abdominal ultrasound were performed to rule out metastatic disease and comorbid conditions; no metastatic lesions or other abnormalities were observed. En bloc surgical excision of the affected skin was performed and the entire tissue was submitted for histopathology. A final diagnosis of cutaneous hemangiolipoma was reached upon extensive sectioning and histologic examination of the larger tissue specimen. The goat recovered well from surgery and has had no further complications up to 9 months postoperatively. To our knowledge, this is the first case report of a hemangiolipoma in a goat and surgical excision for such lesions appears to be a viable treatment method.

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Lung adenocarcinoma as a cause of spontaneous pneumothorax in a cat

Veterinarski glasnik ◽

10.2298/vetgl191227006a ◽

2020 ◽

pp. 6-6

Author(s):

Nenad Andric ◽

Sladjan Nesic ◽

Nikola Krstic ◽

Jelena Francuski-Andric

Keyword(s):

Lung Adenocarcinoma ◽

Clinical Presentation ◽

Complete Blood Count ◽

Lung Tumor ◽

Leukemia Virus ◽

Left Lung ◽

Clinical History ◽

Tumor Formation ◽

Feline Leukemia Virus ◽

The Right

A 15-year-old indoor/outdoor female, neutered, domestic European short haired cat was presented to our clinic with a history of neck-elongation and wheezing during inspiration/expiration. The first signs of respiratory disease occurred two weeks before the clinical presentation. After taking of clinical history, clinical examination and basic laboratory tests (complete blood count, blood smear, snap Feline Immunodeficiency Virus/Feline Leukemia Virus Combo test), a lung x-ray was performed showing the presence of left lung atelectasis and pneumothorax. The primary causes of lung atelectasis were not determined. Given that the general condition of the cat was very bad, she was put in an oxygen cage, thoracocentesis was performed, but the animal?s condition did not improve, and 24 hours after clinical presentation, the cat died. Autopsy revealed the presence of a tumor mass on the caudal lobe of the right lung, tumor formation in the area of trachea bifurcation and changes in the liver in the form of four round structures of different sizes. Histopathologically, the existence of primary undifferentiated lung adenocarcinoma with metastases on the liver and trachea was determined.

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Nephrectomy in a Dog infected with Dioctophyma renale - Mato Grosso do Sul, Brazil

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.117799 ◽

2022 ◽

Vol 50 ◽

Author(s):

Mariana Ramos Santos ◽

Camila Baloque Do Nascimento ◽

Júlia De Mendonça Favacho ◽

Camila Maria Dos Santos ◽

Miwa Fabiane Suzukawa ◽

...

Keyword(s):

Complete Blood Count ◽

Parasitic Infection ◽

Abdominal Ultrasound ◽

The State ◽

Renal Parenchyma ◽

Structure Characteristic ◽

Mato Grosso ◽

Successful Recovery ◽

The Right ◽

Mato Grosso Do Sul

Background: Dioctophymosis is caused by Dioctophyma renale, a parasite known as the giant kidney worm, that can parasitize the kidneys of domestic and wild animals. There are also reports of its occurrence in humans, thus revealing its zoonotic potential. In most cases, parasitized animals are asymptomatic. This parasite can cause atrophy or destroy the renal parenchyma, although ectopic locations may occur. The diagnosis is made through ultrasonography, based on the presence of eggs in the urine, visualization of the parasite, or during necropsy. Therefore, the aim of this work was to report the case of a young dog infected with D. renale and subjected to nephrectomy in the state of Mato Grosso do Sul, Brazil.Case: A 6-month-old bitch with a clinical suspicion of hydronephrosis in the right kidney was referred to the Veterinary Hospital of Anhanguera-Uniderp University in the city of Campo Grande, MS. A physical examination of the patient revealed an alteration in the urinary system. An abdominal ultrasound, urinalysis, complete blood count (CBC) tests and biochemical profile were ordered. The erythrogram indicated erythrocytosis resulting from dehydration and loss of body fluids, while enzyme levels (creatinine, urea, alanine aminotransferase [ALT] and albumin) were within normal limits. The abdominal ultrasound showed the presence of a cylindrical and rounded structure characteristic of a nematode and in the right kidney, and loss of renal parenchyma typical of D. renale infection. A urinalysis then revealed the presence of helminth eggs, confirming the diagnosis. The owner was informed about the need for nephrectomy of the affected right kidney, which showed destruction of the renal parenchyma. One adult female and one adult male parasite were removed from inside the kidney, measuring approximately 50 cm and 35 cm in length. The patient was successfully treated, kept in hospital for observation, and returned two weeks later for reassessment of her renal function and removal of stitches. Discussion: Dioctophymosis is often diagnosed based on ultrasound and urine tests. These tests proved sufficient to diagnose parasitism by D. renale. However, the infection is usually discovered during necropsy. D. renale is popularly known as the giant kidney worm, as it can reach up to 100 cm in length. In the present case, the female parasite was 50 cm long and the male was 35 cm. The patient presented parasitism very young, at just 6 months of age. The parasitic infection of the animal was attributed to the ingestion of water or food contaminated with an intermediate host, the aquatic annelid Lumbriculus variegatus. It is suggested that the ingestion of food or water contaminated with the infective stage of the parasite may have occurred at 2 months of age or younger, since the prepatent period is approximately 6 months. The parasite was found only in the patient’s right kidney. Hydronephrosis was reported in the patient and was caused by obstruction of the internal urethral ostium by the adult nematode. In this case, the recommended surgical treatment was nephrectomy, to which the patient was subjected, leading to successful recovery. This case occurred in the state of Mato Grosso do Sul, where there are no records of parasitism by D. renale in domestic dogs, unlike other states in Brazil. We therefore emphasize the importance of new studies on D. renale, given the lack of clear records describing the parasite’s epidemiological data, biological cycle and diagnosis, which may hinder the prevention and control of this zoonotic disease.Keywords: canine dioctophymosis, helminth, nematoid, giant kidney worm, hydronephrosis.Descritores: dioctofimose canina, helminto, nematoide, verme gigante renal, hidronefrose.

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Comparison of the Aditus ad Antrum Diameter on CT between Patients with Chronic Otitis Media and Healthy Individuals

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405615666190327110216 ◽

2019 ◽

Vol 15 (10) ◽

pp. 990-993 ◽

Cited By ~ 1

Author(s):

Elif Gündoğdu ◽

Uğur Toprak

Keyword(s):

Computed Tomography ◽

Otitis Media ◽

Middle Ear ◽

Healthy Subjects ◽

Normal Values ◽

Chronic Otitis Media ◽

Healthy Individuals ◽

Inner Diameter ◽

Male Patients ◽

The Right

Background: The middle ear cavity is ventilated through the aditus ad antrum. Aditus blockage contributes to the pathology of otitis media. Objective: To determine the normal values of the aditus ad antrum diameter on computed tomography and to investigate its relationship with chronic otitis media and related pathologies (tympanosclerosis and myringosclerosis). Methods: The temporal CT images of 162 individuals were evaluated retrospectively. In the axial sections, the inner diameter of the aditus was measured at the narrowest point at the cortex. The differences in diameter were compared between diseased and healthy ears. Results: In healthy individuals, the diameter was narrower in women. There was no difference between the right and left ears in healthy subjects. No correlation was found between age and diameter. In male patients with myringosclerosis, the diameter was slightly narrower on both sides but more marked on the left. In female patients with myringosclerosis, the diameter in both ears was slightly narrower. In cases of otitis media and tympanosclerosis, the diameter was less than that of healthy individuals, despite the lack of statistically significant result in all cases. Conclusion: The aditus ad antrum was narrower in diseased ears, indicating that a blocked aditus may contribute to the development of otitis media, as well as mucosal diseases.

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Interstitial Lung Disease and Anti-Myeloperoxidase Antibodies: Not a Simple Association

Journal of Clinical Medicine ◽

10.3390/jcm10122548 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2548

Author(s):

Marco Sebastiani ◽

Fabrizio Luppi ◽

Gianluca Sambataro ◽

Diego Castillo Villegas ◽

Stefania Cerri ◽

...

Keyword(s):

Interstitial Lung Disease ◽

Rheumatic Disease ◽

Lung Disease ◽

Interstitial Pneumonia ◽

Usual Interstitial Pneumonia ◽

Clinical History ◽

High Resolution Computed Tomography ◽

Function Testing ◽

And Diffusion

Anti-neutrophil cytoplasmic antibodies (ANCA), mainly anti-myeloperoxidase (MPO) antibodies, have been frequently identified in patients with idiopathic pulmonary fibrosis (IPF). However, their role remains unclear, and only 7–23% of these patients develops clinically overt vasculitis. We aimed to investigate the clinical, serological, and radiological features and prognosis of anti-MPO-positive interstitial lung disease (ILD) patients. Fifty-eight consecutive patients firstly referred for idiopathic interstitial pneumonia and showing serological positivity of anti-MPO antibodies were retrospectively enrolled. For each patient, clinical data, lung function testing, chest high-resolution computed tomography (HRCT) pattern, and survival were recorded. Thirteen patients developed a rheumatic disease during a median follow-up of 39 months. Usual interstitial pneumonia (UIP) was the most frequent ILD pattern, significantly influencing the patients’ survival. In fact, while the 52-week survival of the overall population was 71.4 ± 7.5%, significantly higher than IPF, survivals of anti-MPO patients with UIP pattern and IPF were similar. Forced vital capacity and diffusion lung capacity for CO significantly declined in 37.7 and 41.5% of cases, respectively, while disease progression at chest HRCT was observed in 45.2%. A careful clinical history and evaluation should always be performed in ILD patients with anti-MPO antibodies to quickly identify patients who are developing a systemic rheumatic disease.

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