Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Hemangioma with organizing thrombi
- Radiologic Findings
- Fig 1-3. Mediastinal window setting of the chest CT scan shows a 19-mm-sized nodular lesion in the anterior mediastinum, which closely abuts the body of the sternum. On precontrast CT scan, the nodule shows homogeneous attenuation and lobulated margin without calcification. After contrast administration, the nodule shows marked enhancement (190 HU) mainly in the central portion, which is comparable to those of adjacent vessels. Fig 4. Integrated F-18 FDG-PET/CT scan shows faint FDG uptake (maximum standardized uptake value of 1.8) in the nodule.
- Brief Review
- Hemangioma is a rare, benign vascular tumor that counts for less than 0.5% of all mediastinal masses. It has been speculated that they represent either true neoplasm or developmental vascular anomalies. At histologic examination, these tumors consist of large interconnecting vascular spaces lined by flattened cuboidal epithelium along with a varying amount of interspersed stromal elements, such as fat, myxoid, and fibrinous tissues. Most mediastinal hemangiomas are found in the anterior mediastinum.
Preoperative diagnosis may be difficult because the tumors usually manifest as mediastinal masses with nonspecific image findings. Phleboliths, a potentially diagnostic finding, are seen in only 10% of conventional radiographs. Calcification is more readily identifiable on CT scans. Punctate calcification is seen more commonly and needs to be differentiated from the calcification seen in patients with teratoma or cartilaginous tumor.
Hemangiomas commonly appear as well-circumscribed, heterogeneous soft-tissue masses on unenhanced CT scans. Their appearance depends on the stromal content and degree of thrombosed vascular channels. Contrast enhancement is most often heterogeneous and central. Gradually increasing and persistent enhancement has been seen on dynamic contrast-enhanced CT scans.
- References
- 1. Prachi P., Hean M., Frederic R. Case130: Mediastinal Hemangioma. Radiology 2008; 246:634-637
2. H. Page, Melissa L., Cesar A. Mediastinal Hemangioma: Radiographic and CT Features in 14 Patients. Radiology 1994; 193:399-402
3. Sakurai K., Hara M., Ozawa Y et al., Thoracic hemangiomas: imaging via CT, MR, and PET along with pathologic correlation. J Thorac Imaging 2008;23(2):114-120
- Please refer to
- Case 1009 Case 832 Case 469 Case 245
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- Keywords
- Hemangioma, Mediastinal Hemangioma, anterior mediastinum,