Mediastinal hemangioma

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Mediastinal hemangioma is a location specific subtype of a hemangioma.

Epidemiology

There incidence account for less than 0.5% among all mediastinal masses .

Clinical presentation

Up to half of patients may be asymptomatic . Others may present with non-specific symptoms, such as cough, chest pain, fever or dyspnea (due to compression or adhesion to adjacent structures).

Pathology

As with other haemagiomas, there are benign vascular tumors.

Location

Occurrence within the anterior mediastinum is considered commoner than the posterior mediastinum.

Radiographic features

CT chest

Usually seen as a reasonably well defined mediastinal mass which largely comprises of soft tissue attenuating components but may has occasional fat attenuating and calcific components (the latter likely due to phleboliths).

MRI thorax

Described signal characteristics bear some resemblance to haemagiomas elsewhere and include.

  • T1: often has predominantly intermediate signal intensity where numerous nodular intermediate-signal-intensity areas were interspersed in high-signal-intensity areas that represented fat.
  • T2:
    • ​usually seen as a markedly hyperintense mass lesion with a flow voids, an enlarged vein draining into the inferior vena cava may be present.
    • some areas may show fat suppression due to fat components
  • T1 C+ (Gd): multiple tortuous serpentine enhancing structures may be present (better appreciated with a volume-interpolated breath-hold examination sequence)