Test 3: 39 xray cont

Question 1

extrapleural mass/signs will have — on xrays

Answer 1

Broad-based mass on the chest wall
Convex shape
Lungs displaced medially
+/- Uneven distances between ribs
+/- Lysis of ribs

Most often neoplasia

Question 2

which one pulmonary mass vs extrapleural sign

Answer 2

extrapleural sign:
Broad-based mass on the chest wall
Convex shape
Lungs displaced medially
+/- Uneven distances between ribs
+/- Lysis of ribs

Most often neoplasia

Question 3

what is found in the area of the mediastinum

Answer 3

Heart
Aorta
Vena cava (Cd & Cr)
Trachea
Esophagus
Thymus
Lymph nodes

Question 4

the cranial and caudal ventral mediastinal structures are found —

Answer 4

left side- pushed over by lungs

Question 5

the caudal vena cava is on what side of the body

Answer 5

right

Question 6

Answer 6

Question 7

what is found in the cranioventral mediastinum

Answer 7

sternal lymph nodes
+/- thymus

Question 8

what is found in the craniodorsal mediastinum

Answer 8

Great vessels
 Trachea
 Esophagus
 Cranial mediastinal lymph nodes

Question 9

Answer 9

thymus- in the cranioventral mediastinum

juvenile dogs and cats

sail sign

Question 10

normal thickness of cranial mediastinum

Answer 10

dog- 2x midth of vertebral body
cat- 1x width of vertebral body

unless fat→ may be wider

Question 11

mediastinal masses may appear — on xray

Answer 11

• Midline location
• Widening of the mediastinum on VD – may have round or lobular (“bumpy”) margins
• +/- Dorsal displacement of the trachea
• +/- Caudal displacement of the carina
• +/- Silhouetting with heart

Question 12

Answer 12

wide mediastinum from obese cat

straight sides, no mass effect

Question 13

mediastinal masses in cranioventral location DDx

Answer 13

• Sternal lymphadenopathy
• Thymus→ (ex. Thymoma)
• Abscess
• Mediastinal cyst (especially cats)
• Esophageal diverticulum
• Ectopic thyroid neoplasia

Question 14

mediastinal masses in craniodorsal location DDx

Answer 14

• Cranial mediastinal lymphadenopathy
• Focal esophageal dilation (ex. Vascular ring anomaly)
• Neurogenic tumor
• Vertebral tumor

Question 15

perihilar mediastinal mass DDx

Answer 15

• Tracheobronchial lymphadenopathy
• Heart base mass (like chemodectoma) (top of heart is the base)
• Ectopic thyroid neoplasm

Question 16

mediastinal mass in caudodorsal DDx

Answer 16

• Esophageal mass (or foreign body)
• Hiatal hernia
• Spirocerca lupi-parasite- south USA
• Vertebral tumor
• Paraesophageal abscess

Question 17

caudoventral mediastinal mass location ddx

Answer 17

• Diaphragmatic hernia
• Abscess

Question 18

where is sternal lymph node on xray

Answer 18

usually dont see- are swollen in this xray- can drain into the abdomen

Question 19

where are the tracheobronchial lymph nodes

Answer 19

Perihilar

Middle (Cd) tracheobronchial LN
 Ventral displacement of carina
 Bowing of mainstem bronchi (“bow-legged cowboy”)
 Double opacity sign

Left / Right tracheobronchial LN
 Dorsal displacement of cd trachea
 +/- widening of mainstem bronchi angle on VD

Question 20

large middle tracheobronchial lymph node will move the carina —

Answer 20

ventrally
will also bow the main stem bronchi (bow legged cowboy)
double opacity sign

Question 21

which tracheobronchial lymph node will cause dorsal displacement of the caudal trachea

Answer 21

left or right

+/- cause widening of the mainstem bronchi angle on VD

Question 22

what is this showing

Answer 22

left: enlargment of middle tracheobronchial Lymph node → ventral displacement of carina

right: left atrial enlargment → dorsal displacement of carina

both will show bowing of the mainstem bronchi on VD (cowboy) and double opacity sign

Question 23

Answer 23

mediastinal lymph node enlargement

ventral to trachea
+/- dorsal tracheal displacement
wide/convex cranial mediastinum (not straight line)

Question 24

where are the lymph nodes

Answer 24

mediastinal lymphadenopathy

middle tracheobronchial cause ventral deflection, L and R cause dorsal deflection

widening of mediastinum

Question 25

where are lymphnodes in this pt with medistinal lymphadenopathy

Answer 25

Question 26

what is happening? ddx

Answer 26

cranial mediastinal mass- pushing everything **Thymus** →Neoplasia (Thymoma, Lymphoma); [↓Hemorrhage] **Lymph node** (sternal, cranial mediastinal)→ Neoplasia (Lymphoma) **Mediastinum / Adnexa** →Neoplasia (Sarcoma, Carcinoma); Cyst; [↓ Abscess, Granuloma, Hemorrhage]

Question 27

DDX ## Footnote cat

Answer 27

cranioventral mediastinal mass soft tissue opacity cranioventral to heart widens cranioventral mediastinum DDX: **thyoma** mediastinal cyst lymphoma ## Footnote left sided- thymus

Question 28

dog 11 YP lab with lethargy DDX

Answer 28

heart base mass (perihilar region of mediastinum) → **chemodectoma** soft tissue opacity at heart base, dorsally deviated trachea wide/bulging cranial mediatstinum, trachea deviated to right

Question 29

ddx

Answer 29

caudodorsal mediastinal mass * Caudodorsal mass, cranial convex margin * Focal widening (midline with bulge to right) **hiatal hernia** gas inside structure

Question 30

increased contrast from ---

Answer 30

**pneumomediastinum**- can see things you normal can't see (ventral part of trachea)