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Weekly Chest CasesArchive of Old Cases

Case No : 1215 Date 2021-02-02

  • Courtesy of Min Jae Cha / Chung-ang University Seoul hospital
  • Age/Sex 68 / F
  • Chief ComplaintIncidentally detected a mediastinal mass in Brain and Neck CT angiography
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Mediastinal hemangioma
Radiologic Findings
Fig 1-3. Chest CT images show a 2.4-cm anterior mediastinal mass with heterogeneous enhancement. Peripheral nodular enhancement with central hypoattenuating areas is noted on the post-contrast scan.
Brief Review
Mediastinal hemangiomas are rare vascular tumors that can occur anywhere in the mediastinum. Avid enhancement at CT and MR imaging can be seen and may mimic other vascular lesions such as unicentric Castleman disease. However, hemangiomas tend to have a heterogeneous appearance on CT and may contain fat, fluid, and soft-tissue attenuation. In addition, dynamic imaging after administration of contrast material often shows gradual enhancement that is more pronounced during delayed phases. Similar to other hypervascular lesions, they show intermediate to low signal intensity on T1-weighted images and high signal intensity on T2-weighted images on MRI. Hemangiomas lack FDG uptake on FDG PET/CT.
Please refer to
Case 1009, Case 1034,
KSTR Imaging Conference 2005 Summer  Case 1,
References
1. Cabral FC, Trotman-Dickenson B, Madan R. Hypervascular mediastinal masses: action points for radiologists. Eur J Radiol 2015;84:489-98. 10.1016/j.ejrad.2014.11.039
2. Seth J. Kligerman, Aaron Auerbach, Teri J. Franks, Jeffrey R. Galvin Castleman Disease of the Thorax: Clinical, Radiologic, and Pathologic Correlation: From the Radiologic Pathology Archives. RadioGraphics 2016; 36:1309–1332
Keywords
Mediastinum, hemangioma,

No. of Applicants : 91

▶ Correct Answer : 19/91,  20.9%
  • - ZIGONG TCM HOSPITAL OF CHINA , China CAO CUN YOU
  • - Other , Korea (South) HYEJIN YANG
  • - Ondokuz Mayis University , Turkey CETIN CELENK
  • - , Italy PAOLO BALDASSARI
  • - Chonnam National University Hospital , Korea (South) MOON GYEONG IL
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Hamamatsu University Hospital , Japan HAYATO NOZAWA
  • - HHS , Canada S LEE
  • - Seoul National University Bundang Hospital , Korea (South) SUNG HYUN YOON
  • - Gifu University Hospital , Japan Yo Kaneko
  • - , Japan KANAE TAKAHASHI
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Eskisehir Sehir Hastanesi , Turkey MURAT SAHIN
  • - AIMS , India NITHYA HARIDAS MALIYAM
  • - Kitano Hospital , Japan SATOSHI IKEDA
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - , Japan TOMOKI IMOKAWA
  • - Tokyo Metropolitan Bokutoh Hospital , Japan TOMOKI WADA
  • - Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
▶ Correct Answer as Differential Diagnosis : 29/91,  31.9%
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
  • - TWMU Medical Center East , Japan MASAFUMI KAIUME
  • - Mayo Clinic , United States AKITOSHI INOUE
  • - Chungbuk National University Hospital , Korea (South) YEONGTAE PARK
  • - , Korea (South) HYEYOUNG CHOI
  • - Chonbuk National University Hospital , Korea (South) MINGI SHIN
  • - McGill University Health Center , Canada ALEXANDRE SEMIONOV
  • - Tiger Gate Hospital , Japan SHIN-ICHI CHO
  • - Other , Korea (South) SEONGSU KANG
  • - National Center for Global Health and Medicine , Japan MASATOSHI HOTTA
  • - , Korea (South) HYEWON CHOI
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - Yeungnam University Medical Center , Korea (South) JONGSOO PARK
  • - Soonchunhyang University Hospital Bucheon , Korea (South) SEONGHWAN BYUN
  • - Osaka City General Hospital , Japan SHU MATSUSHITA
  • - Other , Korea (South) MINSU KIM
  • - , Japan HIROAKI ARAKAWA
  • - Capital xray , India SANJEEV KUMAR
  • - Fortis hospital , Mohali , India SHALEEN RANA
  • - Toranomon Hospital , Japan KAORU SUMIDA
  • - National Center for Global Health and Medicine , Japan HIROSHI TAKUMIDA
  • - , Japan KAZUMA TERAUCHI
  • - Private sector , Greece VASILIOS TZILAS
  • - Hamamatsu University Hospital , Japan YUKI HAYASHI
  • - Kyoto university , Japan AKIHIKO SAKATA
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - Hanyang University Hospital , Korea (South) SEUNG JIN YOO
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