Case Study

 
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History:
Paddington Axial
10 year old Border Collie presented to Animal Imaging for evaluation of the sublumbar lymphnodes and prostate.  This patient initially presented to the veterinarian for weakness in the rear limbs and listlessness.  Radiographs of the lumbar spine were obtained at that time and showed enlarged sublumbar lymphnodes.  On physical exam, both distal rear limbs were swollen and painful to palpation.  Ultrasound of the abdomen and radiographs of the thorax and distal rear limbs were obtained.
 
Sonny Thorax USFindings:
Ultrasound exam showed and enlarged prostate with a heteroechoic pattern consistent with infiltrative disease. The sublumbar lymphnodes were enlarged, hypoechoic, and rounded in shape. This was highly suggestive of early metastasis.  The remainder of the abdomen was within normal limits.  Radiographs of the thorax were normal.  There was no evidence of pulmonary metastasis or lymphadenopathy.  A subtle periosteal reaction was noted on the caudal cortex of the distal humerus of both front limbs. This was a smooth non aggressive periosteal reaction.  Radiographs of the distal rear limbs showed soft tissue swelling with a pallisading periosteal reaction along the abaxial margins of the 2nd and 5th digits extending up the limb on both sides of the tarsus and distal tibia.  FNA of the prostate and sublumbar lymphnodes were obtained with ultrasound guidance.
 
Sonny Lat ThoraxImpressions and Recommendations: 
A diagnosis of prostatic carcinoma with metastasis to the sublumbar lymphnodes and hypertrophic osteopathy was made.  Hypertrophic osteopathy is an unusual osteoproductive disorder of the periosteum that affects the long bones of the extremities.  It is usually secondary to cardiopulmonary disease/neoplasia.  It can be seen with non thoracic diseases as well.  Often the patients present with signs of listlessness and swollen distal extremities rather than symptoms related to the primary thoracic or abdominal disease.  The pathogenisis of hyertrophic osteopathy is incompletely understood, but does result in subperiosteal new bone formation that starts at the digits and progresses toward the axial skeleton.
 
Animal Imaging BuildingAnimal Imaging  
Animal Imaging is a referral diagnostic imaging center in Irving offering MRI, Scintigraphy, Radiology, Fluoroscopy and Ultrasound for companion animals and equine patients.
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www.animalimaging.net
Jake Hersman, DVM                   Robert Cole, DVM, DACVR            Susan Willenbrock
Managing Partner                       Imaging Director                               Office Manager
jakehersman@yahoo.com          rcole@animalimaging.net                  susanwillenbrock@yahoo.com 
(972) 869-2180                          (972) 869-2180                                (972) 869-2180