Presentation
Ten-day history of coughing, lethargy, inappetence, and diarrhea with melena. Fever of 104° F on physical exam.
Patient Data
There is a soft tissue opacity mass present in the left caudal lung lobe. The mass is deforming the border between the caudal subsegment of the left cranial lung lobe and left caudal lung lobe on the right lateral projection, confirming its location in the left caudal lobe. There is a small air pocket within the mass. There is increased opacity in the pleural space with visible pleural fissure lines indicating a small pleural effusion.
Pulmonary mass is most likely an abscess however neoplasia with central necrosis is a differential diagnosis.
There is a cavitary, thick walled abscess in the ventral left caudal lung lobe. There are multiple septae in the abscess separating air filled compartments. There is alveolar pattern in the tip of the lung lobe ventral to the lesion. There is mild tracheobronchial lymph node enlargement.
Case Discussion
Differential diagnoses for the left caudal lung lobe mass on radiographs are most likely abscess or granuloma, possibly from an inhaled foreign body, given the fever and young age of the dog as well as the location of the mass. The pleural effusion is most likely inflammatory.
On recheck radiographs over the next month with antibiotics, the fever resolved but the mass persisted. A CT and lung lobectomy were performed and the lung lobe was removed. Histopathology confirmed an abscess but did not identify a foreign body.
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