Ganglioneuroblastom

Newborn with
posterior mediastinal mass on prenatal US. CXR AP (above left) shows a soft tissue mass in the left superior chest causing spreading and erosion of the left first and second rib, and increased distance between the left C7 and T1 transverse processes. Axial CT without contrast of the chest (above right) shows the mass to be densely calcified, in the posterior mediastinum, and displacing and compressing the trachea. Coronal (below left) and sagittal (below right) T1 MRI without contrast of the chest show a posterior mediastinal mass from C7 to T3 that has intraspinal extension.The diagnosis was thoracic ganglioneuroblastoma.
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A ganglioneuroblastoma is a transitional tumor which lies on the intermediate spectrum of disease between a ganglioneuroma and a neuroblastoma.

Epidemiology

They are seen more commonly in children younger than 10 years. There is no definite gender predilection reported at the time of writing.

Pathology

The tumor contains elements of both malignant neuroblastoma and benign ganglioneuroma. They may be encapsulated.

Location

They are commonly attached to a nerve trunk.

Radiographic features

Imaging features can be variable and can range from a solid, well-marginated, oblong paraspinous mass with homogeneous enhancement or as an irregular, cystic, poorly-marginated, locally-invasive mass with evidence of metastatic disease.

Plain radiograph

Non-specific but may hint to an initial diagnosis in larger lesions. May show a posterior retroperitoneal, mediastinal, or neck mass.

Ultrasound

Not a typical imaging modality of choice but may show a heterogeneously echogenic lesion if able to be identified. Anechoic areas may be present corresponding to regions of hemorrhage and/or necrosis

CT

Variable and can range from homogeneous (especially small lesions) to heterogenous (large lesions).

MRI

Maybe be more useful in assessing intraspinal extension.

  • T1: usually low signal intensity; hemorrhagic areas may manifest as areas of high signal
  • T2: usually high signal intensity but heterogenous; cystic areas may be high signal.
  • T1 C+: may show variable enhancement

Calcification may be difficult to detect at MR imaging; signal voids may be apparent.

See also

Siehe auch:
Assoziationen und Differentialdiagnosen zu Ganglioneuroblastom: