Presentation
Referred for bleeding, thrombocytopenia, and anemia.
Patient Data
There is a patchy, diffuse interstitial to alveolar pattern throughout the lungs. There is a more focal alveolar pattern in the left cranial lung lobe which does not completely resolve between the dorsoventral and ventrodorsal projections. The cranial mediastinum appears widened. The heart is mildly enlarged, and the pulmonary vasculature is enlarged with some vessels tapering abruptly.
The patchy interstitial and alveolar infiltrates may represent interstitial edema secondary to vasculitis or hemorrhage. The increased soft tissue opacity in the left cranial thorax may represent a consolidated left cranial lung or mediastinal mass. The distended pulmonary vasculature is suggestive of fluid overload but pulmonary embolism is also possible.
Case Discussion
Immune mediated hemolytic anemia and thrombocytopenia were present. On necropsy, there was secondary microvascular thrombosis and acute sepsis, resulting in embolic pneumonia and early ARDS. No pulmonary vascular emboli were identified at necropsy.
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