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British Journal of Radiology (2007) 80, e238-e240
© 2007 British Institute of Radiology
doi: 10.1259/bjr/97270791
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Posterior mediastinal dumbbell ganglioneuroma with fatty replacement

S-M Ko, MD 1 D-Y Keum, MD 2 and Y-N Kang, MD 3

Departments of 1 Radiology, 2 Thoracic Surgery and 3 Pathology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Republic of Korea


Figure 1
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  		Figure 1. Chest radiograph obtained 3 years previously showing a large mass in the right side of the posterior mediastinum with no rib destruction(arrow).

 

Figure 2
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  		Figure 2. (a) Unenhanced CT scan obtained above the aortic arch shows the right paraspinal tumour composed of both fat and soft tissue attenuation. The mass has some stranding and nodular soft tissue density (arrow) within the fatty area. Note the growth into the neural foramen (arrowhead). (b) Contrast-enhanced CT scan obtained at the level of the carina shows the mass abutting on the descending thoracic aorta (arrow). The soft tissue component shows minimal enhancement.

 

Figure 3
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  		Figure 3. (a) The T1 weighted axial image shows that the mass has not only the low signal intensity of nodular and stranding soft tissue components but also the high signal intensity of the fatty areas. The dumbbell tumour enlarges the right intervertebral foramen of T3–4 and displaces the thecal sac to the left without compression of the spinal cord. (b) On the T2 weighted axial image, the mass extends through the pre-vertebral space to the left posterior mediastinum and encases the descending thoracic aorta without compression. (c) The axial contrast-enhanced T1 weighted image with fat saturation demonstrates that the signal intensity of the fatty areas is reduced but that the nodular and stranding soft tissue components are enhanced.

 

Figure 4
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  		Figure 4. Microscopic findings of the specimen demonstrate an interlacing pattern of adipose tissue and fibrocellular tissue composed of relatively mature ganglion cells, Schwann cells and nerve fibres(inset).

 




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