Radiographic differentiation of mediastinal versus pulmonary masses in dogs and cats can be challenging

Imaging and endoscopic diagnosis of lung diseases in small animals. A review

Diagnostic imaging plays a fundamental role in the diagnosis of pulmonary diseases. Radiography, ultrasound, computed tomography, and endoscopy are important tools for achieving a diagnosis. The choice of diagnostic procedure varies according to the patient, the suspected diagnosis and the risk/benefit ratio. Culture, cytology and histology are nearly always necessary to obtain a definitive diagnosis. Several biopsy sampling techniques are described. Surgical biopsies are the gold standard for the diagnosis of bronchiolitis or interstitial lung diseases but often not performed due to the high risk. In humans, the introduction of transbronchial cryobiopsies has led to excellent results in the study of interstitial lung diseases.

Mediastinal Serous Cavity Mesothelioma in Two Dogs

The mediastinal serous cavity (MSC)-well documented but seldom recognized in the caudal mediastinum-is embryologically derived from the omental bursa. Mesothelioma arising from the MSC in two dogs is described. Both dogs presented with acute life-threatening hemorrhagic pleural effusion. Contrast computed tomography revealed a large solitary spherical-to-cylindrical tumor in the caudal mediastinum with variably thick, contrast-enhancing walls with lobular to frond-like proliferations that arose circumferentially and projected internally into a single, variably sized, fluid-attenuating lumen. The wall and lumen corresponded to the serous membrane and serous cavity of the MSC. Surgical exploration confirmed that both tumors arose from the mediastinum. Both had similar histologic findings, and special stains were necessary for definitive diagnosis. The tumor was nonresectable in one dog, and it was euthanized intraoperatively. The other survived 7 mo. An MSC mesothelioma should be considered a possible cause of hemothorax in dogs that may be detected on thoracic radiography and computed tomography. Differential diagnoses include esophageal foreign body or neoplasm, paraesophageal diaphragmatic hernia, MCS empyema, and pulmonary adenocarcinoma, with thoracic computed tomography helping to rule out foreign body and diaphragmatic hernia. For confirmed neoplasms, histochemistry and immunohistochemistry should be performed to differentiate between mesothelioma and pulmonary adenocarcinoma.

Mediastinal Fibrosarcoma in a Dog–Case Report

This represents the first published case report of mediastinal fibrosarcoma in a dog. An 8-year-old male neutered mixed breed dog was presented for evaluation of lethargy and increased panting. Thoracic focused assessment with sonography for trauma revealed moderate pleural effusion. Thoracic radiograph findings were suggestive of a cranial mediastinal mass. Computed tomography revealed a mass within the right ventral aspect of the cranial mediastinum. On surgical exploration, a cranial mediastinal mass with an adhesion to the right cranial lung lobe was identified and removed en-bloc using a vessel sealant device and requiring a partial lung lobectomy. Histopathology results described the cranial mediastinal mass as fibrosarcoma with reactive mesothelial cells identified within the sternal lymph node. The patient was treated with systemic chemotherapy following surgical removal. To date, the dog has survived 223 days following diagnosis with recurrence noted 161 days following diagnosis and radiation therapy was initiated. Primary cranial mediastinal fibrosarcoma while a seemingly rare cause of thoracic pathology in dogs, should be considered in the differential diagnosis for a cranial mediastinal mass.