Presentation
Presented with recent onset of anorexia, weight loss and hind limb lameness.
Patient Data
There is increased opacity of the cranial mediastinum on the lateral projection, with dorsal tracheal deviation. The cranial mediastinum is mildly widened on the d/v projection. There is also ill-defined increase in soft tissue opacity between the principal bronchi on the dorsoventral projection. In addition, there is a mild, diffuse interstitial pulmonary pattern. The cardiovascular structures are within normal limits. There are small mineral opacities within the stomach.
There is an aggressive bone lesion of the lateral and mid to proximal aspect of the left calcaneus. There is cortical destruction and marked, irregular periosteal proliferation. There is associated extracapsular soft tissue swelling at this site. There is a small, elongated mineral fragment within this soft tissue. the calcaneal tendon is thickened and irregular.
Case Discussion
Systemic aspergillosis with fungal osteomyelitis and lymphadenopathy. Aggressive bone lesions such as these are most often due to osteomyelitis or neoplasia. The finding of enlarged thoracic lymph nodes makes an infectious process most likely. Fungal infection typically causes marked enlargement of thoracic lymph nodes.
Abdominal ultrasound was indicated but not performed in this case. Necropsy revealed fungal osteomyelitis in the calcaneus, a renal mass due to fungal disease, and a diffusely enlarged, mottled spleen as well as lymphadenopathy.
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