7-year-old castrated male Boston Terrier
September 1, 2013
Swelling of submandibular region
- Large area of hyperechoic tissue in the right submandibular (or retropharyngeal) region. Hypoechoic streaking in the subcutaneous tissues surrounds this area.
- Centrally there are multiple ovoid or irregular hypoechoic nodules/structures.
- There is a thin, linear, hyperechoic structure causing distal acoustic shadowing and brief reverberation artifact within one of these structures. It is surrounded by a small rim of anechoic fluid.
- The mandibular salivary gland, ramus of the mandible, hyoid apparatus, and larynx are also imaged and are normal.
- The linear and shadowing structure is highly characteristic of a submandibular foreign body.
- The surrounding tissue indicates cellulitis/abscessation.
- The hypoechoic nodules represent either reactive mandibular lymphadenopathy, pockets of exudate, or a combination of the two.
- Surgical exploration/drainage or ultrasound-guided foreign body removal and drainage are indicated (both acceptable)
- Fine needle aspirate for cytology and culture prior to surgical exploration (this is an appropriate suggestion, though no points awarded for its inclusion or removed if not suggested)