Omega Imagem Veterinária, Av. Washington Luis, Vila Matias, Brazil.
Open Vet J. 2023 Feb;13(2):241-246. doi: 10.5455/OVJ.2023.v13.i2.13. Epub 2023 Feb 22.
Primary lung neoplasms are, frequently represented by solid, solitary, or multiple formations. However, malignant cavitary lesions may be presented as lung adenocarcinomas. Those malignant lesions differ from benignant bullae by the thickness heterogeneity of its surrounding shape.
The present clinical case reports a 14-year-old female dog, of mixed breed, with an increase in the coughs frequency, fatigue, and exercise intolerance. A chest X-ray was taken, a large emphysematous cystic area was found, with thickened and irregular walls located in the left caudal pulmonary lobe, which measured 8 × 7.5 × 3 cm, and rejected the bronchial branch corresponding to the left caudal pulmonary lobe, in addition to thickening of the bronchial walls, compatible with bronchopathy. The tomographic examination of the cavity showed an air content structure, oval to round in shape, with irregular thick hyperattenuating walls measuring approximately 0.4 cm in thickness, occupying more than 30% of the left hemithorax, and pulmonary lobectomy was chosen. Histopathology confirmed the diagnosis of bronchoalveolar adenocarcinoma, with the presence of sparse areas of necrosis and dystrophic calcification.
The present case successfully diagnosed a malignant bulae, after a surgical remove. The tomographic finds although not confirmatory, suggest a malignant component by the shape and thickness of its wall. The tomographic exam is of great importance, because only through it, it is possible to evaluate if there is lymph node or pleural involvement or the presence of small metastasis foci. There is indication for surgery and histopathological examination of the piece for a definitive diagnosis.
原发性肺部肿瘤常表现为实性、单发或多发的形态。然而,恶性空洞性病变可能表现为肺腺癌。这些恶性病变与良性大疱的区别在于其周围形状的厚度不均一性。
本临床病例报告了一例 14 岁的雌性犬,混种犬,表现为咳嗽频率增加、疲劳和运动不耐受。拍摄了一张胸部 X 光片,发现左肺下叶有一个大的气囊肿性区域,有增厚和不规则的壁,大小为 8×7.5×3cm,且拒绝了与左肺下叶相应的支气管分支,此外,支气管壁增厚,符合支气管病。空洞的断层扫描显示有一个气腔结构,呈椭圆形至圆形,有不规则的厚高衰减壁,厚度约为 0.4cm,占据了左半胸的 30%以上,选择了肺叶切除术。组织病理学证实了支气管肺泡腺癌的诊断,存在稀疏的坏死区和营养不良性钙化区。
本病例成功诊断了一例恶性大疱,通过手术切除。虽然断层扫描结果不能确诊,但通过其形状和壁的厚度提示存在恶性成分。断层扫描检查非常重要,因为只有通过它才能评估是否存在淋巴结或胸膜受累或存在小的转移灶。需要进行手术和组织病理学检查以明确诊断。