section content

  • Treated by rDVM for pneumonia for several weeks with clavamox, only partially responsive.
  • Came to AMC for advanced imaging additional diagnostics and therapy.
caption
caption
caption
caption
caption
caption
caption
caption
1 / 8
  • Marked bronchial dilation: cranial portion of the left cranial lung lobe.
  • Bronchial walls are moderately/markedly thickened, including the left cranial lung lobe.
  • There is fluid within the most ventral/distal portion of the dilated bronchi.
  • On one series, right cranial lung lobe is completely opacified with air bronchograms caudally and a caudal lobar sign, indicating an alveolar pattern. A left lateral view would be helpful to better characterize the extent of the alveolar pattern and evaluation whether or not the right middle lobe is affected.
  • The cardiac silhouette normal.
  • Pulmonary vessels are not clearly demarcated due to the overlying bronchial and interstitial pattern, but they are not dilated.
  • The cranial mediastinum and trachea are normal.
  • The CT confirms the radiographic findings.
  • Additionally, marked bronchial dilation is present in the right caudal and right cranial lung lobes, with marked intraluminal fluid accumulation within the bronchi in the right cranial lobe.
  • Marked generalized bronchial and interstitial inflammation (bronchitis): infectious, inflammatory (including eosinophilic bronchopneumopathy), allergic and/or parasitic in origin.
  • Severe cranial lung lobe bronchiectasis (cylindrical) and intrabronchial fluid/secretions. Indicates chronicity.
  • Right cranial lung lobe bronchopneumonia.
  • The lung pathology is severe for a rather young patient. A congenitall mucociliary clearance defect might be present.
  • Necropsy revealed a severe eosinophilic pneumonopathy with bronchiectasis, bronchiolitis obliterans with organizing pneumonia.

Histopathology

  • Markedly dilated bronchiole contains intense eosinophilic infiltrates within the lumen, intermixed with mucin and cell debris. Eosinophils are also observed within other bronchioles and bronchi. Surrounding these airways, there are popula=ons of lymphocytes, plasma cells, and macrophages. Macrophages multifocally contain goldenbrown, granular pigment (hemosiderin). The regional parenchyma contains foci of hemorrhage. The dilated airways compress the surrounding pulmonary parenchyma, with multifocal expansion of the alveolar septa by macrophages, neutrophils, and smaller numbers of eosinophils. Smaller airways throughout the sections contain neutrophils and eosinophils within the lumina with mild smooth muscle hyperplasia. Multifocally, there are nodular like foci within ectatic bronchioles, consisting of fibrous connective tissue which is highly vascularized, intermixed with hemosiderin containing macrophages, neutrophils, and eosinophils. These nodules are adhered to the airway submucosa (bronchiolitis obliterans). In some sections, hemosiderin containing macrophages are prominent throughout the alveolar spaces.
caption
caption
1 / 2