FNA Thoracic Mass

10 responses to “FNA Thoracic Mass”

1. Sedation vs anesthesia very

   Sedation vs anesthesia very dependant on the patient. In calm/relaxed animals there is often no need for sedation and easily done under US guidance. FNA done the same way as you would aspirate an abominal mass/liver/etc. Looking at the radiographs, seems that you would be able to visualize the mass in the right caudal lung field with US.

2. Sedation vs anesthesia very

   Sedation vs anesthesia very dependant on the patient. In calm/relaxed animals there is often no need for sedation and easily done under US guidance. FNA done the same way as you would aspirate an abominal mass/liver/etc. Looking at the radiographs, seems that you would be able to visualize the mass in the right caudal lung field with US.

3. Randy take a look at the

   Randy take a look at the arrows to approach the lesions closest to the body wall. Have a tech compress the lung under sedation like this technique in resources: http://sonopath.com/resources/interventional-procedures/lindquist-compression

   and look for consolidations similar to what is present in this case in the archive: http://sonopath.com/members/case-studies/cases/pulmonary-carcinoma-diagnosed-lung-fna-12-year-old-fs-kerry-blue-terrier

   measure out well how far you need to put the needle into the consolidated lung so you don’t end up doing a CVC or cardiac blood sample 🙂 but you should be fine away form anything dangerous given the caudal aspect of the lung lesions.

4. Randy take a look at the

   Randy take a look at the arrows to approach the lesions closest to the body wall. Have a tech compress the lung under sedation like this technique in resources: http://sonopath.com/resources/interventional-procedures/lindquist-compression

   and look for consolidations similar to what is present in this case in the archive: http://sonopath.com/members/case-studies/cases/pulmonary-carcinoma-diagnosed-lung-fna-12-year-old-fs-kerry-blue-terrier

   measure out well how far you need to put the needle into the consolidated lung so you don’t end up doing a CVC or cardiac blood sample 🙂 but you should be fine away form anything dangerous given the caudal aspect of the lung lesions.

5. Thank you EL. The last

   Thank you EL. The last suggestion cleared things up for me. I will let you know how this

   turns out.

6. Thank you EL. The last

   Thank you EL. The last suggestion cleared things up for me. I will let you know how this

   turns out.

7. Shortly after I posted the

   Shortly after I posted the x-rays I brought Takota back in for a FNA of the lungs. I must admit I never could identify a solid mass therefore cytology was not submitted- although I did do an aspirate where I felt there was pathology. Nothing worth sending in.I started Takota on Prednisone and a shot of convenia. He is doing a bit better. RRR is in the mid to high 20’s/minute- but he is still wheezing.

   I did offer the owners a referral to an internal medicicine specialist- but they said they would not go that far.

   Here are the follow up x-rays one week later. 

   I see some improvement- but I still think neoplasia is a possiblity here. 

   Any possiblity this could be chornic airway disease with fibrosis and calcification. Almost hoping for something similar to COPD.

   Hey Dr O’brien- if you ever check in I would also value your imput.

    

   Thanks

    

    

8. Shortly after I posted the

   Shortly after I posted the x-rays I brought Takota back in for a FNA of the lungs. I must admit I never could identify a solid mass therefore cytology was not submitted- although I did do an aspirate where I felt there was pathology. Nothing worth sending in.I started Takota on Prednisone and a shot of convenia. He is doing a bit better. RRR is in the mid to high 20’s/minute- but he is still wheezing.

   I did offer the owners a referral to an internal medicicine specialist- but they said they would not go that far.

   Here are the follow up x-rays one week later. 

   I see some improvement- but I still think neoplasia is a possiblity here. 

   Any possiblity this could be chornic airway disease with fibrosis and calcification. Almost hoping for something similar to COPD.

   Hey Dr O’brien- if you ever check in I would also value your imput.

    

   Thanks

    

    

9. Neoplasia typically doesnt

   Neoplasia typically doesnt get better in a week but that event doesnt rule it out. Unfortunately now the right caudal lesion is tougher to stick because its resolving. Its a tough first stick if you haven’t done lung fna in the past. The key is to count the ribs, left side recumbency after sedation and look for the consolidation compressing the lung with your scanning hand til you get a window to the non aerated consolidation. Look at my instruction on lung compression technique.

   https://sonopath.com/resources/interventional-procedures/lindquist-compression

   Here are some applicable cases:

   http://sonopath.com/members/case-studies/search?text=lung+mass+fna&species=All

10. Neoplasia typically doesnt

    Neoplasia typically doesnt get better in a week but that event doesnt rule it out. Unfortunately now the right caudal lesion is tougher to stick because its resolving. Its a tough first stick if you haven’t done lung fna in the past. The key is to count the ribs, left side recumbency after sedation and look for the consolidation compressing the lung with your scanning hand til you get a window to the non aerated consolidation. Look at my instruction on lung compression technique.

    https://sonopath.com/resources/interventional-procedures/lindquist-compression

    Here are some applicable cases:

    http://sonopath.com/members/case-studies/search?text=lung+mass+fna&species=All