Bovine Jersey, female, 5 year and 6 months of age. History of operation 2 years before for a foreign body in the reticulum. Now presented for increased inspiratory noise. Radiographs of the head were taken. Laterolateral radiography of the laryngeal region Radiographic findings
- The radiograph is mildly oblique.
- The visible bony structures are within normal limits.
- There is a well defined structure of soft tissue opacity, semicircular in shape, with a smooth surface protruding in the nasopharynx, dorsal to the soft palate at the level of the epiglottis.
- The cranial part of the nasopharynx is open and air filled, subjectively dilated.
Radiolographic Diagnosis
- Soft tissue space occupying lesion dorsal to the soft palate with incomplete upper airways obstruction.
- DD cyst (congenital or acquired), abscess, granulom, neoplasia, hematoma.
Close up of the lateral view with the described soft tissue opacity protrunding in the nasopharynx (arrow) SP:Soft palate
- An endoscopy examination was performed.
- A cystic structure, covered by epitelium similar to the soft palate was visible in the nasopharynx.
- The cyst was completely excised and submitted to histological examination.
- Histologically the diagnosis was confirmed: It was a cyst covered by stratified squamous epithelium, most likely compatible with a congenital malformation. No histological sign for neoplasia or abscess were found.
Comments
- Sinonasal cysts are rare findings described within the nasal passages, paranasal sinuses and chonchae.
- They are more often congenital abnormalities but may also gradually and slowly increase in size over time, and then become clinically relevant or evident in adult animals.
- Nasal cysts can also be acquired entities, secondary to parastic infestion, foreing body, chronic inflammation of the nasal passages.
- Fluid have the same radioopacity than soft tissue, then the list of differential diagnosis should include fluid filled structures (like cystic structures of any origin, congenital, parasitic or hematomas) as well as soft tissue structures (granulomas, abscesses, neoplasias, polyps).
- Depending on the location, a CT examination or endoscopy are recommended for further evaluation of the lesion, considering that cysts can be multiple, can arise in different location and progressively expand causing bone deformation, nasal discharge or obstruction or get infected.
- The treatment of choice is complete removal of the cysts thorugh endoscopy or surgery, depending on the location.
