Today’s case is a 12-year-old female neutered DSH cat with intermittent pyrexia and vomiting. What are your findings?
Findings
There is wet hair coat artifact present on the body wall. The cardiac silhouette is enlarged on all projections, and the pulmonary vasculature is normal in size. The cardiac silhouette appears rounded on the ventrodorsal projection. There is increased soft tissue opacity in the pleural space with retraction of the lung lobes and pleural fissures lines. The pleural effusion obscures the heart on the dorsoventral projection but is less apparent in the ventrodorsal projection. The pulmonary parenchyma appears normal. In the portion of the abdomen included, the peritoneal detail is decreased.
Differential Diagnosis
The enlarged heart may be due to primary cardiac disease or pericardial effusion. The pleural and peritoneal effusion may indicate a systemic inflammatory (FIP) or neoplastic disease (round cell neoplasia). Primary pericardial effusion may also cause secondary pleural and peritoneal effusion. Ultrasound examination of the heart and abdomen are recommended.
Diagnosis
On abdominal ultrasound, the spleen was enlarged as well as several mesenteric lymph nodes. Fine needle aspirates were obtained and large cell lymphoma was suspected.
A brief cardiac ultrasound confirmed pericardial effusion. The tricavitary effusion was presumed to be due to neoplasia. Further workup was declined.
Only in the right lateral proyection I see a line of soft tissue opacity in the 4th intercostal space that seems to extend to the 6th. Could this be a plate-like atelectasis? Thank you