PMC5808972_01
Dorsoventral and left lateral radiographs obtained at the primary veterinary clinic, demonstrating a soft tissue mass, cranial and dorsal to the cardiac silhouette, deviating the carina sternally. An alveolar pattern was present in the right middle and accessory lung lobes
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Radiography showed evidence of a soft-tissue mass, cranial and dorsal to the cardiac silhouette, deviating the carina sternally (Figure 1).
CT images of the heart base mass. The dorsal minimum intensity projection (left) shows compression of the right principal bronchus (arrowhead) and complete occlusion of the left principal bronchus (arrow). The transverse post-contrast section (right) illustrates the location and extent of the mass above the heart and great vessels (hyperintense with contrast) in addition to bilateral bronchial compression, as before
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Images showed a large, contrast-enhancing mass at the heart base, which deviated the oesophagus dorsally and compressed the lumen of both principal bronchi, entirely obliterating the lumen of the left (Figure 2).
Postoperative dorsoventral and left lateral radiographic projections, obtained after needle thoracocentesis to drain a small pneumothorax. The bilateral bronchial stents are visible (left side indicated by arrow), as is some evidence of pulmonary pathology, which was considered most likely secondary to chronic bronchial obstruction. The position of the proximal portions of the stents alongside one another in the distal trachea is referred to as 'kissing stents' and reduces the risk of stent re-obstruction
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Repeat radiographs showed resolution of pneumothorax and persistence of alveolar infiltrates, predominantly in the left lung (Figure 3).
Dorsoventral and left lateral radiographic projections obtained 4 weeks after stent deployment, obtained to investigate worsening of respiratory signs. An interstitial-alveolar pattern is visible diffusely in the lung fields, worst in the right caudal lobe. Stent position and conformation was appropriate, with no evidence of migration or fracture
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There was no evidence of pneumothorax or pleural effusion, but a bronchointerstitial pattern was present throughout the lungs, worst caudodorsally on the right (Figure 4).
Still frame from bronchoscopy, showing no stent occlusion or malposition but a small amount of mucus accumulation. Bronchoalveolar lavage samples suggested that this was associated with bacterial infection
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Bronchoscopy showed no evidence of stent occlusion (Figure 5), but excessive mucus production was evident, especially on the right.