Presentation
Presented with 2-week history of dry, hacking cough, lethargy, and anorexia.
Patient Data
There is a large soft tissue mass dorsal to the carina which is depressing the mainstem bronchi ventrally. The mass is widening the mainstem bronchi on the dorsoventral projection, as well as widening the mediastinum cranial to the carina. There is a small amount of gas in the esophagus on the left lateral projection which appears to be deviated dorsally over the mass. The remainder of the pulmonary parenchyma and airways are normal. No abnormalities are noted in the pulmonary vasculature and the cardiac silhouette is normal.
A CT examination was performed that illustrates the ventral deviation, spreading, and compression of the mainstem bronchi (arrows) by the mass.
Case Discussion
Histiocytic sarcoma caused the enlarged tracheobronchial lymph node that compressed the heart dorsally, and laterally deviated and narrowed the mainstem bronchi.
Differentials for hilar lymphadenopathy - round cell neoplasia such as lymphoma, histiocytic sarcoma, or granuloma.
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