Archive of Old Cases
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- Archive of Old Cases
- 2021
Case No : 1236 Date 2021-06-28
- Courtesy of Soyeoun Lim, WOON-JUNG KWON / Ulsan University Hospital
- Age/Sex 30 / M
- Chief ComplaintAbnormal chest radiograph finding on health check-up A 30 years old man without prior medical history
Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Ganglioneuroma
- Radiologic Findings
- (1) Radiograph shows a double-contour of the right cardiac border (bulging of the right paraspinal line).
(2) Chest CT shows right-sided posterior mediastinal mass, measured 4.4x1.7x5.7 cm. This mass is relatively well-circumscribed and shows homogenous, poor enhancement (~30HU). T-spine MRI shows T1 low, T2 heterogeneous indeterminate, and STIR high signal intensity. On the enhanced T1 image, the mass shows marginal rim enhancement and poor central enhancement.
- Brief Review
- Ganglioneuromas (GN) are rare, slowly growing, asymptomatic benign tumors that originate from primitive neural crest cells, estimated to account for 0.1% to 0.5% of all CNS system tumors. GN are mainly distributed in the mediastinum (41.5%), retroperitoneum (37.5%), and neck (8%) as they arise from sympathetic ganglia along the spinal column and adrenal glands. Most commonly occurs in young age patient under 20 years old. GN contains heterogeneous compositions such as Schwann cells, mature ganglion cells, nerve fibers, and mucus matrix. Therefore, they appear as the heterogenous hypodense mass on CT scans. GN may contain puntate or discrete calcifications. On MRI, it shows hypointensity on T1WI, heterogeneous hyperintensity on T2WI, and hyperintensity on fat-suppression image. Surgical resection is the best treatment option and prognosis is usually good without complication.
- Please refer to Case 807, Case 641, Case 637, Case 91,
- References
- 1. Posterior Mediastinal Ganglioneuroma, Radiographics 2004; 24:594–597
2. Imaging Analysis of Ganglioneuroma and Quantitative Analysis of Paraspinal Ganglioneuroma, Med Sci Monit. 2019; 25: 5263–5271
3. Muller’s imaging of the chest, Elsevier, p1065-1066
- Keywords
No. of Applicants : 98
- ▶ Correct Answer : 37/98, 37.8%
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- - Ishikawa Matto Central Hospital , Japan MANABU AKIMOTO
- - , Japan HIROAKI ARAKAWA
- - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
- - Showa General Hospital , Japan MASAFUMI KAIUME
- - Mayo Clinic , United States AKITOSHI INOUE
- - Ajou University School of Medicine , Korea (South) JUNG YONG JUN
- - Osaka Red Cross Hospital , Japan YUSUKE UTSUNOMIYA
- - Seoul National University Bundang Hospital , Korea (South) SOWON JANG
- - , France CHARLES DAMIEN
- - Tiger Gate Hospital , Japan SHIN-ICHI CHO
- - Ichinomiya Nishi Hospital , Japan CHIHIRO KIGUCHI
- - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
- - Ajou University Hospital , Korea (South) KYUNGMIN LEE
- - Other , Korea (South) SEONGSU KANG
- - , Korea (South) JIN YOUNG LEE
- - Osaka University , Japan AKINORI HATA
- - Ajou University Hospital , Korea (South) HAEIN LEE
- - Shimada General Medical Center , Japan HAYATO NOZAWA
- - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
- - Gifu University Hospital , Japan Yo Kaneko
- - VDC, HYDERABAD , India KARTHIK RAYASAM
- - , Japan KANAE TAKAHASHI
- - The University of Tokyo Hospital , Japan RYO KUROKAWA
- - Ajou University Hospital , Korea (South) DAYOUNG KIM
- - Mallinckrodt Institute of Radiology , United States NAGANATHAN MANI
- - Maimonides Medical Center , United States NAOMI TWERSKY
- - , Japan HIROAKI ARAKAWA
- - Asan Medical Center , Korea (South) BYUNGSOO IM
- - Kyoto University Hospital , Japan SATOSHI IKEDA
- - Pusan National University Yangsan Hospital , Korea (South) JI HWAN KIM
- - Toranomon Hospital , Japan KAORU SUMIDA
- - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
- - , Japan KAZUMA TERAUCHI
- - Chonnam National University Hospital , Korea (South) SEUNG WAN KANG
- - National Center for Global Health and Medicine , Japan TOMOKI IMOKAWA
- - , Japan YUKI HAYASHI
- - Kyoto university , Japan AKIHIKO SAKATA
- ▶ Correct Answer as Differential Diagnosis : 13/98, 13.3%
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- - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
- - Other , Korea (South) HYEJIN YANG
- - Chonbuk National University Hospital , Korea (South) MINGI SHIN
- - , Italy PAOLO BALDASSARI
- - Other , Korea (South) KEUNTAK ROH
- - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
- - Osaka City General Hospital , Japan SHU MATSUSHITA
- - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
- - CHU Lille , France PAUL LEBERT
- - Osmania Medical College, Hyderabad , India PURUSHOTHAMA RAO TUMMALA
- - Fortis hospital , Mohali , India SHALEEN RANA
- - the first affiliatited hospital of nanjing medical univercity , China HAI XU
- - algeria , Algeria ZAKARIA CHERAGA
- ▶ Semi-Correct Answer : 14/98, 14.3%
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- - , Korea (South) HYEYOUNG CHOI
- - Inje University Haeundae Paik Hospital , Korea (South) HYUNGIN PARK
- - Chungbuk National University Hospital , Korea (South) JIYUN KANG
- - HHS , Canada S LEE
- - Samsung Medical Center , Korea (South) KYOWON GU
- - Soonchunhyang University Hospital Bucheon , Korea (South) SEONGHWAN BYUN
- - Chungbuk National University Hospital , Korea (South) MIHYEON PARK
- - Other , Korea (South) MINSU KIM
- - Seoul National University Hospital , Korea (South) SE WOO KIM
- - Seoul Veterans Hospital , Korea (South) SEONG WON JANG
- - , Saudi Arabia RAWAN AHMED ALJEFRI
- - Apollo Hospitals , India SHRUTHI P
- - Chonbuk National University Hospital , Korea (South) DONG HAN SHIN
- - Chonbuk National University Hospital , Korea (South) YOUNG JU SONG
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