- Lymphoma: Facts
- Hodgkins is most common in the anterior mediastinum
- Nodes rarely calcify unless the patient has undergone radiation therapy or occasionally chemotherapy
- Parenchymal involvement at time of presentation is rare (under 10%)
- Non-Hodgkin’s disease more commonly involves the lung parenchyma - Anterior Mediastinal Mass: Differential Diagnosis
- Lymphoma
- Germ cell tumor
- Thymoma
- Thyroid goiter
- Inflammatory nodes like TB or Sarcoidosis
"CT and MR imaging of the thorax are helpful to characterize lesions initially identified at plain radiography. This characterization helps narrow the differential diagnosis when a lesion is detected in this location." Lesions of the Cardiophrenic Space: Findings at Cross Sectional Imaging
Pineda V et al.
RadioGraphics 2007; 27:19-32 - Pericardial Cyst: Facts
- More common in right cardiophrenic space (77%)
- Congenital in origin
- Always asymptomatic
- Attenuation usually 0-20 HU
- No enhancement on contrast enhanced studies - Lesions of the Cardiophrenic Space: Differential Diagnosis
- Prominent cardiac fat pad
- Diaphragmatic hernia (Morgagni hernia)
- Pericardial fat necrosis
- Pericardial cysts
- Thymic tumors
- Lymphoma
- Adenopathy - Paraganglioma: Facts
Paragangliomas are found predominantly in the abdomen (85%) and the thorax (12%), and only 3% are found in the head and neck region. Most occur as single tumors. When they occur in multiple sites they are usually found as a part of a heritable syndrome such as multiple endocrine neoplasia types II-A and II-B and SDH-related mutations. - Paraganglioma: Facts
- Rare neuroendocrine tumors of chromaffin cell origin
- When they arise outside the adrenal glands in extraadrenal neuroendocrine tissue they are called paragangliomas
- May arise in the chest from the aortic body - Paraganglioma: Facts
- Patients may have mutations in the mitochondrial II genes SDHB, SDHC and SDHD
- 15% of these tumors are extra-adrenal, 85% adrenal in origin (pheochromocytoma) - Paragangliomas: CT Findings
- Vasular lesions especially well enhanced on arterial phase imaging
- Multiple lesions at multiple sites may be seen in select cases and may be part of a familial disorder as well
- Carney syndrome- paraganglioma, pulmonary chondroma, and GI stromal tumor - Paragangliomas
"Paragangliomas of the aortic body and the great vessels have a characteristic imaging appearance. They originate from known sites of the branchiomeric paraganglia such as the aortic body."
Cross-Sectional Imaging of Paragangliomas of the Aortic Body and Other Thoracic Branchiomeric Paraganglia Balcombe J et al.
AJR 2007; 188:1054-1058 - Paragangliomas
"Aortic body paragangliomas are accompanied by other synchronous paragangliomas in 10% of cases."
Cross-Sectional Imaging of Paragangliomas of the Aortic Body and Other Thoracic Branchiomeric Paraganglia Balcombe J et al.
AJR 2007; 188:1054-1058 - Paragangliomas and Syndromes
- Carney’s triad Paraganglioma, pulmonary chondroma, and GIST tumor
- Hereditary Paraganglioma (J Med Genet 2002; 39:617-622) - Branchiomeric Paraganglia: Some Sites
- Carotid body
- Coronary paraganglia
- Pulmonary paraganglia
- Jugulotympanic paraganglia
- Subclavian paraganglia
- Laryngeal paraganglia - Extraadrenal Paragangliomas: CT Findings
- Homogeneous or heterogeneous hyperenhancing mass
- Range in size from 1 cm to over 20 cm
- Common locations are carotid body, jugular foramen, aorticopulmonary region, posterior mediastinum, abdominal paraaortic region including Organ of Zuckerkandl, and pelvis - Paraganglioma: Facts
- Neuroendocrine tumor which arises from the paraganglionic cells
- Pheochromocytoma is a paraganglioma of the adrenal gland
- Usually 4th and 5th decades of life
- 10% are clinically silent and picked up incidentally - Paraganglioma: Facts
- Familial Paragangliomas are 10% of cases
- 35-50% of familial cases are multicentric
- Occur with MEN IIA and IIB, tuberous sclerosis, neurofibromatosis, and von Hippel Lindau disease. Also part of Carney’s triad with gastric leiomyosarcoma, chondroma and extraadrenal paraganglioma - Paraganglioma: Facts
"Although paragangliomas can occur in a variety of anatomic locations, the majority are seen in relatively predictable regions of the body."
Extraadrenal Paragangliomas of the Body: imaging Features
Lee KY et al.
AJR 2006; 187:492-504 - "Paragangliomas of the aortic body and the great vessels have a characteristic imaging appearance. They originate from known sites of the branchiomeric paraganglia such as in the aortic body."
Cross-Sectional Imaging of Paragangliomas of the Aortic Body and Other Thoracic Branchiomeric Paraganglia
Balcombe J et al.
AJR 2007; 188:1054-1058 - "Aortic body paragangliomas are accompanied by other synchronous paragangliomas in about 10% of cases."
Cross-Sectional Imaging of Paragangliomas of the Aortic Body and Other Thoracic Branchiomeric Paraganglia
Balcombe J et al.
AJR 2007; 188:1054-1058
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