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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.