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134 Bronchiolar and Pulmonary Neoplasia

PEARLS & CONSIDERATIONS that predispose to its development (e.g., inflam- resolved by lobectomy). In patients with
mation, infection). multifocal or diffuse disease, recurrent secondary
Comments
VetBooks.ir • Bronchiectasis is generally secondary to Technician Tips life-threatening.
bacterial infections are common and can be
an underlying condition, although the
• When preparing for respiratory washes, use
primary disease (e.g., bacterial pneumo-
possible, prewarm solutions in a 37°C
nia) may have resolved by the time of solutions without bacteriostatic additives. If SUGGESTED READING
Hawkins EC, et al: Demographic, clinical, and
evaluation. incubator (or suitable alternative). radiographic features of bronchiectasis in dogs: 316
• Management of secondary bacterial infections • Before performing a lavage in a cat, admin- cases (1988-2000). J Am Vet Med Assoc 223:1628-
should be based on culture and sensitivity ister a bronchodilator. Provide supplemental 1635, 2003.
to minimize antibiotic resistance. oxygen before and after the procedure. AUTHORS: Laura A. Nafe, DVM, MS, DACVIM
EDITOR: Megan Grobman, DVM, MS, DACVIM
Prevention Client Education
The best means of preventing bronchiectasis is Owners must understand that bronchiectasis
early identification and treatment of diseases is not curable (unless focal disease can be

Bronchiolar and Pulmonary Neoplasia Client Education
Sheet

BASIC INFORMATION effusion. Definitive diagnosis requires cell
HISTORY, CHIEF COMPLAINT sampling.
Definition • Often an incidental finding
Malignant growth in the pulmonary paren- • Respiratory signs are common (e.g., respira- Differential Diagnosis
chyma that may be primary (bronchiolar or tory distress, cough, tachypnea, hemoptysis). • Granuloma (e.g., fungal pneumonia)
alveolar) or metastatic • Weight loss is sometimes recognized, as are • Abscess
lethargy and hyporexia. • Hematoma
Synonyms • In cats, vomiting and diarrhea often noted • Lung lobe torsion
Lung cancer, pulmonary neoplasia, metastatic • Lameness is occasionally noted. • Pulmonary parasites
pulmonary neoplasia, pulmonary metastasis ○ Cats: pulmonary adenocarcinoma or • Pulmonary eosinophilic infiltrates
squamous cell carcinoma can metastasize • Lymphoid granulomatosis
Epidemiology to the digits • Fluid or blood filled bulla
SPECIES, AGE, SEX ○ Dogs: hypertrophic osteopathy
• Dogs and cats of either sex Initial Database
• Mean age: dogs, 11 years; cats, 12-13 years PHYSICAL EXAM FINDINGS • Complete blood count (CBC), chemistry
• Usually no findings specific for pulmonary panel, urinalysis: often unremarkable
GENETICS, BREED PREDISPOSITION tumors • Thoracic radiographs: large solitary or
Breeds that may be overrepresented are boxers, • Auscultation might reveal multiple pulmonary masses
Doberman pinschers, Australian shepherds, ○ Increased bronchovesicular sounds ○ Solitary, well-defined nodule more likely
Irish setters, Bernese mountain dogs and, among ○ Decreased heart and lungs sounds ventrally to be primary lung cancer
cats, possibly Persians. if pleural effusion present ○ Nodular interstitial pattern more likely
○ Decreased lung sounds over an area of to be metastatic cancer. Often, nodules
RISK FACTORS large mass vary in size.
Dogs with primary lung cancer have increased • Neurologic abnormalities (metastasis to ○ Histiocytic sarcomas often large mass/
anthracosis (accumulation of carbon within the central nervous system [CNS]) entire lobe with internal air bronchogram
bronchial mucosa and pulmonary parenchyma) • Poor body condition ○ Lymphoma has a varied appearance,
compared to normal dogs, suggesting exposure • Lameness (hypertrophic osteopathy, digital including alveolar, nodular, or unstruc-
to pollution may play a role in lung cancer metastasis) tured interstitial patterns; bronchial
development. • Distant primary tumor may be recognized infiltrates; or masses.
anywhere on the body with metastatic lung • Abdominal imaging (radiographs, ultrasound,
ASSOCIATED DISORDERS cancer. or CT): with primary lung tumors, abdomi-
Hypertrophic osteopathy nal imaging often normal. With metastatic
Etiology and Pathophysiology lung cancers, abdominal imaging sometimes
Clinical Presentation • Continual unregulated cellular proliferation identifies a primary tumor.
DISEASE FORMS/SUBTYPES • Experimentally, smoking and inhaled plu- ○ If a tumor is recognized in the abdomen
Malignant neoplasia: tonium increased occurrence in dogs or limbs, fine-needle aspirate for cytology
• Bronchoalveolar carcinoma (most common can provide a likely diagnosis for meta-
primary lung tumor in dogs) DIAGNOSIS static lung disease.
• Adenocarcinoma (most common primary
lung tumor in cats) Diagnostic Overview Advanced or Confirmatory Testing
• Adenosquamous cell carcinoma Primary lung cancer is often incidentally found • Thoracic CT scan: more sensitive than
• Squamous cell carcinoma on screening radiographs or found on thoracic radiography for assessing number/size
• Histiocytic sarcoma radiographs performed for workup of coughing of pulmonary masses, tracheobronchial
• Lymphoma as solitary or multiple pulmonary masses. lymph node size, and may help plan
• Metastatic tumors to lungs Approximately 30% of cats also have pleural surgery

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