Presentation
Presenting for acute respiratory distress and weight loss.
Patient Data
The heart is moderately enlarged, seen best on the lateral projections. There are multiple pulmonary nodules of soft tissue opacity, as well as a larger mass in the right caudal lung lobe. There is opacification of the right cranial thorax with uniform soft tissue opacity. Between the dorsoventral and ventrodorsal projections, the soft tissue material is static. The lung lobes are retracted slightly with surrounding soft tissue opacity. The cardiac silhouette is enlarged. In the portion of the abdomen included, the liver is enlarged and extends beyond the costal arch. There is a small, smooth osseous body cranial to one humerus.
Case Discussion
Pulmonary neoplasia with pulmonary metastasis and probable neoplastic pleural effusion. Cardiac disease with heart failure may be contributing to the pleural effusion and pulmonary pattern.
On echocardiogram, there was right atrial and ventricular enlargement with tricuspid insufficiency. Pleural fluid contained carcinoma on cytology.
Carcinomatosis is the spread of neoplasia, most often carcinoma, into the peritoneal or pleural space. It is more common in the abdomen, however can also be seen in the thorax.
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