Radiographic and computed tomographic characteristics of intraluminal tracheal adenoma in a cat.

A 13-year-old spayed female Persian cat presented with dyspnea and nasal discharge. Thoracic radiography revealed a dome-shaped soft-tissue opacity in the carina. Computed tomography confirmed a soft tissue-attenuating mass in the carina and the left and right proximal main bronchi that appeared to arise from the tracheal wall. Tracheoscopy revealed an intraluminal broad-based mass with multilobulated borders at the same location. Histopathological evaluation revealed a benign neoplastic process of the glandular epithelial lineage, which was considered an adenoma. Tracheal adenomas should be included in the differential diagnosis of tracheal masses.

Solitary tracheal B-cell lymphoma in an adult alpaca (Vicugna pacos).

BACKGROUND: This report describes a case of solitary tracheal lymphoma in a 14-year-old alpaca mare. CASE PRESENTATION: The alpaca was referred for dyspnea and inspiratory noise. The clinical examination included complete blood cell count, blood chemistry, endoscopy, ultrasound, radiographs, and computed tomography (CT). A solitary tracheal intraluminal and juxtatracheal lymphoma was diagnosed by fine needle aspiration (FNA). The owner requested euthanasia due to the uncertain prognosis. At postmortem examination, the presence of solitary lymphoma without involvement of other organs was confirmed. Immunohistochemical analysis confirmed a B-cell origin. CONCLUSIONS: Although multicentric lymphoma is the most commonly described neoplasia affecting South American camelids (SAC), solitary forms of the disease may occur.

Removal of a Tracheal Myelolipoma in a Cockatiel (Nymphicus hollandicus) by Surgical Resection and Anastomosis.

A 17-year-old, female cockatiel (Nymphicus hollandicus) was presented for a 1-week history of respiratory distress. The clinical signs were consistent with tracheal obstruction; therefore, an air sac cannula was placed to reduce respiratory compromise. Radiographic images of the patient revealed a round, intraluminal, soft tissue opacity in the trachea. The obstruction could be visualized via transtracheal illumination, but tracheoscopy was not feasible because of the size of the patient. Attempts to manually extirpate the obstruction were unsuccessful, and the trachea subsequently avulsed in the midcervical region. Tracheal resection and anastomosis was performed, and the obstruction was removed with the associated tracheal ring. The patient recovered uneventfully and was doing well at follow-up evaluations at 9 days, 24 days, and 10 months after the surgical procedure. The histologic diagnosis was ossifying myelolipoma arising from bone marrow within the tracheal ring.

Use of endoscopic-guided electrocautery ablation for treatment of tracheal liposarcoma in a dog.

CASE DESCRIPTION A 7-year-old 44-kg (97-lb) neutered male Great Pyrenees was referred for evaluation because of episodic dyspnea with cyanosis of 1 to 2 weeks' duration. Three days prior to evaluation, the clinical signs had worsened, including 1 episode of collapse. CLINICAL FINDINGS Thoracic radiography and CT revealed a well-delineated soft tissue mass, located approximately 1.5 cm cranial to the carina and occupying almost 90% of the tracheal lumen. A CBC and serum biochemical analysis were performed, and all results were within reference limits. TREATMENT AND OUTCOME Tracheoscopy confirmed the presence of a broad-based bilobate mass that was protruding from the right dorsal aspect of the trachea and occupied almost the entire tracheal lumen. The mass was successfully resected by endoscopic-guided electrocautery ablation. Findings of histologic evaluation were consistent with a diagnosis of liposarcoma. Immediately following the ablation procedure, the previously noted clinical signs of respiratory tract disease resolved. On follow-up examination 12 months later, no regrowth of the mass was evident on thoracic helical CT and tracheoscopy. CLINICAL RELEVANCE Endoscopic-guided electrocautery ablation of tracheal liposarcoma was a safe and effective minimally invasive treatment for the dog of this report. The procedure was brief and appeared to be well tolerated, resulting in immediate improvement of clinical signs.

Endoscopic treatment of an intrathoracic tracheal osteochondroma in a dog.

CASE DESCRIPTION: A 1.5-year-old spayed female Bernese Mountain Dog was examined for a 6-month history of intermittent vomiting, regurgitation, wheezing, and coughing. Initially, a diagnosis of gastroesophageal reflux disease with secondary aspiration pneumonitis was made but clinical signs did not resolve with treatment. CLINICAL FINDINGS: Thoracic and cervical radiography and CT revealed a sessile, irregularly marginated soft tissue opacity at the level of the fourth rib. Results of a CBC, serum biochemical analysis, and urinalysis were within reference limits. Results of abdominal ultrasonography were normal. TREATMENT AND OUTCOME: Tracheoscopy revealed a firm, irregularly marginated mass apparently originating from the ventral aspect of the trachea, occluding approximately one-half of the tracheal lumen, and located 2 cm cranial to the carina. Cytologic and histopathologic examination of fine-needle aspirate and biopsy samples suggested a benign etiology; therefore, endoscopic minimally invasive laser and electrocautery resection of the mass was scheduled. A total IV anesthetic protocol was administered with an oxygen-air mixture used to decrease the risk of fire during tracheal surgery. The mass was successfully resected, and histopathologic examination confirmed a diagnosis of osteochondroma. Clinical signs resolved, and at follow-up 32 months later, no regrowth of the mass was evident. CLINICAL RELEVANCE: Tracheoscopy-guided electrocautery and surgical diode laser resection was successful in removing an obstructive tracheal mass that was not resectable by means of a conventional open surgical approach. Minimally invasive procedures may decrease morbidity and mortality and improve outcome in appropriately selected small animal patients.

Presumptive acute lung injury following multiple surgeries in a cat.

A 12-year-old, 3.5-kg spayed female domestic shorthair cat had a tracheal mass identified as malignant B-cell lymphoma. The cat had tracheal resection and subsequently developed laryngeal paralysis. Due to multiple episodes of respiratory distress the cat subsequently had tracheal surgeries. Finally, the cat had a sudden onset of severe respiratory distress and collapsed. Computed tomography imaging and arterial blood gas analysis supported a diagnosis of acute lung injury.

Blessure pulmonaire aiguë présumée après plusieurs chirurgies chez un chat. Une chatte commune domestique stérilisée âgée de 12 ans qui pesait 3,5 kg avait une masse trachéale identifiée comme un lymphome B malin. La chatte a eu une résection trachéale et a ensuite développé une paralysie laryngienne. En raison de plusieurs épisodes de détresse respiratoire, la chatte a ensuite subi des chirurgies trachéales. Enfin, la chatte a souffert soudainement d'une détresse respiratoire et s'est effondrée. Une tomographie par ordinateur et une analyse des gaz du sang artériel a appuyé un diagnostic de blessure pulmonaire aiguë.(Traduit par Isabelle Vallières).

Diagnosis and treatment of tracheal basal cell carcinoma in a Maine coon and long-term outcome.

A 6 yr old castrated male Maine coon presented with a 2 wk history of progressive dyspnea. Thoracic radiographs revealed a 2 cm diameter intratracheal mass at the level of the fourth rib. The tracheal mass was marginally excised via a combination of resection and anastomosis. Infiltrative basal cell carcinoma (BCC) with nodular osseous metaplasia was diagnosed. The thoracic trachea was then irradiated postoperatively for definitive treatment. The cat remained asymptomatic following surgical excision and radiation therapy for 32 mo when this report was written. The purpose of this report is to describe the treatment and long-term outcome of a Maine coon diagnosed with, and treated for, tracheal BCC.

Carcinoma of the trachea in a cat.

Non-keratinizing squamous cell carcinoma of the trachea was diagnosed in an 11-year-old domestic shorthaired cat suffering from progressive cough and dyspnoea. The tumour was characterized by immunohistochemical expression of cytokeratins and focal expression of vimentin. The cat was exposed historically to high concentrations of environmental cigarette smoke and this may have been a contributory aetiological factor in the genesis of this tumour.

Computed tomography of a cat with primary intratracheal lymphosarcoma before and after systemic chemotherapy.

A 12 yr old male neutered domestic shorthair cat presented with worsening tachypnea of 1 mo duration and open mouth breathing. Radiographs revealed tracheal narrowing at the thoracic inlet. Computed tomography (CT) revealed a contrast enhancing 8-cm long fusiform mass within the dorsal tracheal membrane. Tracheobronchoscopy confirmed the presence of the tracheal mass at the thoracic inlet, and lymphoma was diagnosed based on uniformly atypical lymphoid cells on aspirated bronchoalveolar lavage fluid. The cat was treated with combination chemotherapy consisting of cyclophosphamide, vincristine, doxorubicin, and prednisolone. Thoracic radiographs and CT performed 1 mo after completion of the 6 mo chemotherapy protocol revealed resolution of the tracheal mass. The cat remained clinically normal at 21 mo after treatment.

Anaesthetic and surgical management of an intra-tracheal mass in a cat.

An 11-year-old, 7 kg male neutered domestic shorthair cat, presented to the University Veterinary Hospital (UVH) for investigation of chronic tachypnoea and dyspnoea. Radiographs, bronchoscopy and computerised tomography (CT) demonstrated an intra-tracheal mass measuring 13 mm × 5 mm × 6 mm arising from the right wall of the caudal trachea immediately cranial to the carina. Due to size and position, debulking and subsequent cryosurgery were attempted to minimise the amount of tissue removed and prevent recurrence. A combination of anaesthetic techniques was required to allow cryotherapy, with the trachea open whilst maintaining adequate ventilation. This case report demonstrates that cryotherapy in conjunction with anaesthetic planning, can achieve a positive outcome for the cat.

Computed tomography characteristics of canine tracheobronchial lymph node metastasis.

Tracheobronchial lymph node evaluation is critical for accurate staging of canine thoracic neoplasia and is more accurately achieved with computed tomography (CT) than radiography. Thoracic CT scans of 18 canine patients with known tracheobronchial lymph node histopathology and 10 clinically normal dogs were compared to establish if enlargement or contrast enhancement pattern correlated with metastatic status. Absolute lymph node size and three anatomically normalized lymph node ratios were significantly correlated with metastasis or severe granulomatous lymphadenitis (P < 0.0003). Transverse maximum lymph node diameter of 12 mm or lymph node to thoracic body ratio of 1.05 are proposed cutoffs, above which metastatic involvement is very likely; however, only minimal accuracy was gained with normalized ratios. Lymph node contrast enhancement pattern was also significantly correlated to disease. A heterogenous and/or ring pattern was related to metastatic disease (P = 0.03). Recommended protocol for CT examination of the tracheobronchial lymph nodes is 1-1.5 mm slices and intervals, intravenous contrast, and control of respiratory motion.

Analysis of tidal breathing flow volume loop in dogs with tracheal masses.

OBJECTIVES: To investigate whether there are any changes in the tidal breathing flow volume loop (TBFVL) in calm, non-dyspnoeic dogs with intratracheal masses. METHODS: We compared 4 dogs with intratracheal masses (group 1) with 10 healthy dogs (group 2). Routine clinical and laboratory examinations of the dogs were unremarkable, except for episodic upper respiratory obstructive signs in the dogs in group 1. Lateral radiography of the neck and thorax showed that group 1 dogs had masses that appeared to protrude into the tracheal lumen. Tracheoscopy and surgery or necropsy was performed to confirm the presence of the mass. Arterial blood gas and TBFVL analysis was carried out in all dogs to assess respiratory status. RESULTS: The shape of the TBFVL for dogs in group 1 was narrower and ovoid compared with that for the group 2 dogs. Tidal volume and expiratory and inspiratory times were significantly reduced, whereas the respiratory rate was increased for dogs in group 1 compared with dogs in group 2. Arterial blood gas analysis was unremarkable for all dogs. CONCLUSIONS: TBFVL is a non-invasive technique that is easy to perform and well tolerated by dogs. In the absence of abnormalities detected by routine diagnostic evaluations and arterial blood gas analysis in dogs with intratracheal masses, the TBFVL contributes to the definition of the physiologic status of the airways at the time of testing, and results suggests that these dogs breathe quite normally when they are calm and non-dyspnoeic.

Obstructive lesions and traumatic injuries of the canine and feline tracheas.

Tracheal obstruction and tracheal injury can be life-threatening conditions in dogs and cats. Early identification of associated clinical signs and the use of appropriate diagnostic and therapeutic techniques are important to patient survival. Common causes of tracheal obstruction reported in the veterinary literature include tracheal foreign bodies and tracheal tumors. Tracheal injury has been associated with endotracheal intubation and external trauma. Radiography and tracheoscopy are effective diagnostic modalities, and tracheal repair or resection and anastomosis are the most common treatments.