Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Imaging Findings of Pneumothorax Caused by Bronchial Cartilage Hypoplasia in a Dog

개에서 기관지 연골 저형성에 의해 발생한 기흉의 영상학적 진단 증례

  • Kim, Su-yeon (Department of Veterinary Medical Imaging and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University) ;
  • Kim, Seong-soo (Department of Veterinary Medical Imaging and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University) ;
  • Lee, Jeo-soon (Department of Veterinary Medical Imaging and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University) ;
  • Yun, Soo-kyung (Department of Veterinary Medical Imaging and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University) ;
  • Oh, Hyun-jung (Department of Veterinary Medical Imaging and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University) ;
  • Shon, Jung-min (Department of Veterinary Medical Imaging and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University) ;
  • Kim, Bo-eun (Department of Veterinary Medical Imaging and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University) ;
  • Kim, Wan-hee (Department of Veterinary Medical Imaging and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University) ;
  • Yoon, Jung-hee (Department of Veterinary Medical Imaging and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University) ;
  • Choi, Min-cheol (Department of Veterinary Medical Imaging and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University)
  • Accepted : 2015.09.14
  • Published : 2015.10.30
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Abstract

A 10-year-old, castrated poodle dog presented with a cough for 2 weeks, and the cough initially developed since very young age. On radiographs, pneumothorax was noticed by characteristics of radiolucent area without pulmonary markings along the thoracic wall and diaphragm, retracted lung lobes from the thoracic wall and severely decreased volume of the left cranial lung lobe with disconnected bronchus. Computed tomography (CT) findings identified several pulmonary air-filled cysts and collapsed lung with abnormal shape and non-tapered end of bronchus, bronchioles at the accessory lobe and left cranial lobe. Also, pneumothorax, pneumomediastinum and subcutaneous emphysema were found. Imaging diagnosis was the spontaneous pneumothorax caused by ruptured emphysematous bullae associated with congenital bronchial cartilage abnormality or bronchial tree malformation. On surgery, hypoplasia of the left cranial lobe, right middle lobe, and accessory lobe with a bulla where air was leaking was identified. The accessory lobe was partially resected and bronchial cartilage hypoplasia was confirmed by histopathologic examination.

10년령의 중성화된 수컷 Poodle이 기흉이 의심되어 내원하였다. 어릴 때부터 기침증상을 보이다가 약 2주 전부터 악화되었으며, 혈액검사 및 요검사에서 유의적인 특이소견은 발견되지 않았다. 흉부 방사선 영상에서 기흉 소견 및 좌측 전엽 부위 기관지의 단절과 고도로 감소된 폐 실질이 관찰되었다. 흉부의 CT 영상 검사에서, 좌측 전엽과 덧엽에서 몇 개의 cyst들과 허탈된 폐가 관찰되었다. 또한 이 부위에서 기관지와 세기관지들은 비정상적인 형태로 끝부분이 가늘어지지 않았으며, 그 외에도 기흉, 기종격, 그리고 피하 기종이 확인되었다. 이러한 영상학적 특징들로부터 기종성 수포의 파열에 의해 발생한 자발성 기흉이 고려되었으며, 그 원인으로는 선천적인 기관지의 이상 또는 기관지 가지의 기형이 고려되었다. 부분적인 폐 덧엽 절제술이 실시되었으며, 좌측 전엽, 우측 중엽, 그리고 덧엽의 저형성이 확인되었고 특히 덧엽에서는 공기가 새고 있는 수포가 확인되었다. 조직병리학적 검사를 통해 기관지 연골 저형성으로 최종 진단되었다.

Keywords

References

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