Bullae

Case contributed by Allison L Zwingenberger
Diagnosis certain

Presentation

Routine thoracic radiographs.

Patient Data

Age: 12 years
Gender: Castrated male
Category: Domestic dog
Organism: Border Collie

Thorax

x-ray

There are multiple thin-walled, air filled lucencies throughout the lungs. These bullae are visible on all projections. They are best seen superimposed over the diaphragm.

Case Discussion

These lesions are most consistent with congenital bullae or bronchogenic cysts.

Pulmonary bullae are occasional incidental findings on thoracic radiographs. They are thin-walled and often multiple, with distribution in many lung lobes. Thinner-walled lesions would be more compatible with emphysema, and thick or irregularly walled lesions are more likely to be infectious, neoplastic or parasitic in origin. Any bullous lesion can rupture and cause pneumothorax.

A list of potential differential diagnoses includes

  • bulla (emphysema, congenital)
  • pulmonary cyst
  • bronchogenic cyst
  • parasitic (Paragonimus kellicotti)
  • abscess
  • pneumatocele (secondary to pneumonia or trauma)
  • neoplasia

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