Abstract
We present a case of mediastinal paraganglioma with radiologic–pathologic correlation. A 48-year-old woman was found incidentally to have a middle mediastinal mass on CT. The mass showed iso-signal intensity compared to that of muscle on T1-weighted images and high signal intensity on T2-weighted images. The lesion showed intermediate intensity on diffusion-weighted imaging, and its apparent diffusion coefficient was 1.72 × 10−3 mm2/s. A contrast-enhanced dynamic study revealed a rapid peak and washout enhancement pattern. 18F-FDG-PET revealed abnormal uptake in the mediastinal tumor with a maximal standardized uptake value of 7.88. 123I-meta-iodobenzylguanidine scintigraphy also showed abnormal uptake in the tumor. These findings corresponded to the hypervascularity, rich stroma, low nuclear/cytoplasmic ratio, and nest-forming proliferation of tumor cells with positive neuroendocrine markers.
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Balcombe J, Torigian DA, Kim W, Miller WT. Cross-sectional imaging of paragangliomas of the aortic body and other thoracic brachiometric paraganglia. AJR Am J Roentgenol. 2007;188:1054–8.
Yamamoto J, Masuda D, Shimanouchi M, Hashizume T, Numata T, Shiozawa T, et al. A case of middle mediastinal paraganglioma. JJSRE. 2010;32:285–90 (in Japanese with English abstract).
Blandino A, Salvi L, Faranda C, Spadaro P, Perrotta F, Maiello F, et al. Usual malignant paraganglioma of the anterior mediastinum: CT and MR findings. Eur J Radiol. 1992;15:1–3.
Flickinger FW, Yuh WT, Behrendt DM. Magnetic resonance imaging of mediastinal paraganglioma. Chest. 1988;94:652–4.
Paul S, Jain SH, Gallegos RP, Aranki SF, Bueno R. Functional paraganglioma of the middle mediastinum. Ann Thorac Surg. 2007;83:e14–6.
Wang H, Ye H, Guo A, Wei Z, Zhang X, Zhong Y, et al. Bladder paraganglioma in adults: MR appearance in four patients. Eur J Radiol. 2011;80:e217–20.
Aschenbach R, Basche S, Vogl TJ, Klisch J. Diffusion-weighted imaging and ADC mapping of head-and-neck paragangliomas: initial experience. Klin Neuroradiol. 2009;19:215-9.
Hatakenaka M, Soeda H, Yabuuchi H, Matuso Y, Kamitnai T, Oda Y, et al. Apparentdiffusion coefficients of breast tumors: clinical application. Magn Reson Med Sci. 2008;7:23–9.
Uhl M, Altehoefer C, Kontny U, Il’yasov K, Buchert M, Langer M. MRI-diffusion imaging of neuroblastomas: first results and correlation to histology. Eur Radiol. 2002;12:2335–8.
Matsumoto J, Tanaka N, Yoshida Y, Yamamoto T. Resection of an intrapericardial paraganglioma under cardiopulmonary bypass. Asian Cardiovasc Thorac Ann. 2013;21:476–8.
Taieb D, Neumann H, Rubello D, Al-Nahhas A, Guillet B, Hindie E. Modern nuclear imaging for paragangliomas: beyond SPECT. J Nucl Med. 2012;53:264–74.
Lee KY, Oh YW, Noh HJ, Lee YJ, Yong HS, Kang EY, et al. Extraaderenal paragangliomas of the body: imaging features. AJR Am J Roentgenol. 2006;187:492–504.
Whitten CR, Khan S, Munneke GF, Grubnic S. A diagnostic approach to mediastinal abnormalities. Radiographics. 2007;27:657–71.
Madan R, Chen JH, Dickenson BT, Jacobson F, Hunsaker A. The spectrum of Castleman’s disease: mimics, radiologic pathologic correlation and role of imaging in patient management. Eur J Radiol. 2012;81:123–31.
Khalil G, Gaspard D, Jreige M, Nawfal G. Diffusion-weighted whole-body imaging with background body signal suppression in Castleman’s disease. Clin Imag. 2013;37:185–8.
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Takashima, Y., Kamitani, T., Kawanami, S. et al. Mediastinal paraganglioma. Jpn J Radiol 33, 433–436 (2015). https://doi.org/10.1007/s11604-015-0436-z
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DOI: https://doi.org/10.1007/s11604-015-0436-z