Presentation
Presents with a soft, non-productive cough.
Patient Data
There are multiple mediastinal masses visible. There is marked enlargement of the sternal lymph node and enlargement of the hilar lymph node. There is a large soft tissue mediastinal mass that is displacing the trachea dorsally. A round soft tissue nodule is present cranial to the heart on both lateral projections which is likely in the cranial mediastinum since the caudal border of it silhouettes with the heart. The cranial mediastinum is markedly widened on the d/v projection.
The liver extends caudal to the costal arch on both lateral projections and has a rounded caudal margin. The cardiovascular structures appear within normal limits.
Case Discussion
Lymphoma with multiple mediastinal lymph node involvement. The diagnosis was obtained by cytology.
Generalized lymphoma often results in enlargement of lymph nodes within the thorax. Normally, the mediastinal lymph nodes, sternal lymph node and hilar lymph nodes are not seen on thoracic radiographs. When they are enlarged, they cause increased soft tissue opacity in the area and mass effects on neighboring structures. The cranial mediastinal lymph nodes can deviate the trachea dorsally, and the hilar lymph nodes can deviate the main stem bronchi ventrally.
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