PMC4294593_01
Axial (A) and coronal (B) reformatted CT images obtained after after intravenous contrast agent administration showed a fluid-like mass with multiple enhancing internal septa. Of note, a capsular solid nodule is detectable in the middle of the tumor mass.
poljradiol-80-22-g001.jpg
PMC4294593_01_poljradiol-80-22-g001.jpg
f1-poljradiol-80-22
The lesion was characterized by fluid density, regular margins and internal septa in the upper portion; after contrast injection, only the walls, septa and a capsular nodule showed a significant enhancement (Figure 1).
T2 TSE axial (A) and coronal (B) MR images: the mass is hyperintense compared to muscular tissues but presents multiple internal septa. T1 VIBE axial MR images after after intravenous contrast agent administration (C, D): the mass shows clear internal fluid content with a significant enhancement of walls and septa, particularly in the anterior portion.
poljradiol-80-22-g002.jpg
PMC4294593_01_poljradiol-80-22-g002.jpg
f2-poljradiol-80-22
To better characterize the structure of the lesion and to formulate a diagnostic hypothesis, chest MRI with contrast administration was also performed using a 1.5 T MR device (Philips, Achieva, Netherlands) before and after intravenous administration of gadopentetate dimeglumine (120 cc); MRI images confirmed the presence of a voluminous plurilobate cystic mass (14x4.5x7 cm), hypointense on T1 sequence and hyperintense on T2 sequence, with regular margins located in the antero-superior mediastinum (Figure 2).
(A, B) Axial 18F-FDG PET/CT shows tracer uptake in the capsular portion of the mass (SUV max 2) and focal intense uptake (SUV max 5.7) was clearly detected in the middle of the lesion.
poljradiol-80-22-g003.jpg
PMC4294593_01_poljradiol-80-22-g003.jpg
f3-poljradiol-80-22
The PET/CT images showed 18F-FDG uptake in the capsular portion of the mass (SUV max 2) and focal intense tracer uptake (SUV max 5.7) was clearly detected in the middle of the lesion (Figure 3).
Axial CT images at the level of the pulmonary artery bifurcation obtained after after intravenous contrast agent administration before (A) and after (B) a cicle of steroid therapy: there is a significant size reduction of the mass suggestive of disease regression.
poljradiol-80-22-g004.jpg
PMC4294593_01_poljradiol-80-22-g004.jpg
f4-poljradiol-80-22
CT scan was performed. CT images demonstrated a significant size reduction of the mass with no detectable cardiac or pulmonary compression and no pleural effusion (Figure 4).