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case_images: Right lateral radiograph showing marked gas tracking within the cervical soft tissues (black arrowheads), most severe surrounding the pharynx/larynx, with subjective thickening of the laryngeal soft tissues (black asterisk)
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case_images: Cervicothoracic radiographs revealed marked gas tracking within cervical soft tissues, with concurrent pneumomediastinum and aerophagia (Figure 1).
case_images: Right lateral radiograph showing pneumomediastinum and multilobar, ventrally distributed bronchocentric soft tissue nodules (black arrowhead) containing dystrophic mineralization. There is a soft tissue opacity at the heart base (black asterisk), correlating to the tracheal mass identified on CT. The white asterisk identifies esophageal dilation suggestive of aerophagia. The black dagger correlates to the axillary/caudal mediastinal mass identified on CT
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case_images: Multilobar, ventrally distributed bronchocentric soft-tissue nodules containing dystrophic mineralization and a diffuse bronchial pattern were also observed (Figure 2).
case_images: Endoscopic view of the right-sided subglottic mass obscuring the tracheal lumen
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case_images: A large pink mass measuring approximately 5 x 4 mm arising from the right subglottic region was visible within the trachea, obstructing virtually the entire lumen and precluding passage of a cuffed endotracheal tube (Figure 3).
case_images: Endoscopic view of the larynx after biopsy and debulking of the right-sided subglottic mass
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case_images: The right-sided, rostral mass was removed using 4 mm Sontec cup biopsy forceps (Figure 4) and the patient was intubated with a 4.5 mm cuffed endotracheal tube.
case_images: Sagittal and transverse thoracic CT images showing a rounded soft-tissue mass (asterisk) associated with the ventral margin of the distal trachea at the level of the bifurcation, causing marked luminal narrowing of the trachea
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case_images: There was a rounded soft-tissue mass associated with the ventral margin of the distal trachea at the level of the bifurcation, causing marked luminal narrowing of the trachea and proximal mainstem bronchi (Figure 5).
case_images: Transverse thoracic CT image showing multifocal pulmonary abnormalities
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case_images: There were multifocal, patchy and nodular soft-tissue opaque regions of lung consolidation (some bronchus-associated), most pronounced within the ventral aspects of the cranial lung lobes, as well as multifocal mineral foci within the pulmonary parenchyma (Figure 6).
case_images: Post-mortem appearance of the remaining subglottic mass after fixation in 10% neutral buffered formalin. A large exophytic mass (asterisk) arising from the mucosa occupies the lumen
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case_images: Gross examination identified masses described during ante-mortem examination (Figures 7 and 8).
case_images: Post-mortem appearance of the tracheal mass. At the carina is an obstructive, soft but firmly attached white mass (asterisk). The lungs are atelectatic and congested
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case_images: Gross examination identified masses described during ante-mortem examination (Figures 7 and 8).
case_images: Representative histology of the carinal mass. (a) The mass effect is appreciated in this low-magnification view confirming the mass arising from and thickening the mucosa. H&E, x4. (b) Higher magnification of a superficial portion of the mass highlighting the massive eosinophilic inflammation with fewer plasma cells and histiocytes. Normal respiratory epithelium is not present and instead the mass is covered by squamous epithelium indicating metaplasia. H&E, x20. (c) Intranuclear eosinophilic inclusion bodies identified occasionally within the epithelial cells (arrowhead). Inclusion bodies are magnified in the inset. H&E, x40. (d) Immunohistochemical staining against FHV-1 highlighting brown cytoplasmic staining in affected cells. x40. FHV-1 = feline herpes virus-1; H&E = hematoxylin and eosin
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case_images: In addition, there was epithelial squamous metaplasia and dysplasia with infrequent intranuclear inclusion bodies positive for FHV-1 on immunohistochemistry (Figure 9).