Imaging Department

Feb 05th, 2013 Reported by Dr. Giang

Name: Hoang Thi Lan Anh Sex: Female Age: 5 years old Dept: Out patient

Clinical

Cough

Vomitus cruentus (2 times)

No fever

No anemia

Chest Xrays

Oval mass extending over several rib interspaces Right side of Dorsal Vertebras. ( D7 - D11)

Ultrasound

Hypoechogenic mass superior to Right Diaphragm.

Chest CT Findings(Pre C+)

Well-defined Right posterior mediastinal mass Oval shape & homogenous density. No Calcification or necrosis intra mass

Chest CT Findings(Post C+)

Mild homogenous enhance Compress SVC & Right Lung. Rib & vertebra : not invaded.

Chest CT Findings(Post C+, lung parenchyma)

Right Lung lower lobe: compressed by mass.

Both Lung parenchyma: normal.

Diagnosis

Ganglioneuroma

Background of Ganglioneuroma Terminology: Sympathetic ganglion tumors in mediastinum. 4

type: 1. Neuroblastoma: Malignant neoplasm of neural crest cells.

o Nonencapsulated

o Heterogeneous: Hemorrhage, necrosis, cystic degeneration

2. Ganglioneuroblastoma : neuroblastoma mature

o More homogeneous in between neuroblastoma and ganglioneuroma

3. Ganglioneuroma: ganlioneruroblastoma mature. (benign)

o Encapsulated; homogeneous tissue

4. Paraganglioma : Neuroendocrine tumor of chromaffin cell origin

o Highly vascular

o May produce catecholamines

Age: Neuroblastoma < 3, Ganglioneuroblastoma 3-10, Ganglioneuroma> 10

Location: Elongated, vertical posterior mediastinal mass (paraspinal)

Treatment: Surgical ressection. Chemotherapy, radiationtherapy for advanced disease.