PMC6159259_01
A scout film of the CT scan of the chest shows a paraspinal soft tissue density that obscures the left supralateral margin of the aortic arch (arrow).
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The scout film obtained during the CT scan of the chest showed a lesion that obscured the normally seen left supralateral contour of the aortic arch (Figure 1).
Axial (a) and sagittal (b) non-contrast CT scan shows a well-demarcated left paraspinal mass, abutting the posterior aspect of the descending thoracic aorta (arrow in b) The central portion of the mass has a fatty density (arrow in a).
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An unenhanced CT scan of the chest demonstrated a well-circumscribed left paraspinal mass measuring 3.3 x 5.6 x 9.2 cm in the transverse, anterioposterior and craniocaudal diemnsions respectively, abutting the descending thoracic aorta and the posterior left fifth through seventh ribs (Figure 2).
Sagittal T1 (a) sagittal T1 postcontrast with fat suppression (b) and sagittal STIR images show a left paraspinal mass with a fatty component. The inherent T1 hyperintensity of the fatty component of this lesion (solid arrow in a) suppresses on both the postcontrast fat sat (solid arrow in b) and the STIR images (solid arrow in c). The soft tissue component (dashed arrow in a) of the mass shows heterogeneous enhancement (dashed arrow in b). STIR, short tau inversion-recovery.
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T1 shortening of the central portion of the lesion was suppressed with fat suppression techniques, confirming the central fatty component (Figure 3). The peripheral portion demonstrated mainly intermediate-to-low signal intensity on T1 weighted images and intermediate signal intensity on T2 weighted images. The peripheral soft tissue components of the mass showed heterogeneous enhancement after the administration of intravenous gadolinium-based contrast. There was no evidence of bony erosion, reactive oedema or remodelling in either CT or MRI scan (Figure 4).
(a) Axial T2 weighted image shows the well-demarcated margin of the left paraspinal mass (arrow) abutting the descending thoracic aorta. (b) Sagittal T2 weighted image shows the whorled appearance of the mass. (c) Sagittal short tau inversion-recovery image shows that the mass causes no reactive changes or invasion of the adjacent ribs (arrow).
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T1 shortening of the central portion of the lesion was suppressed with fat suppression techniques, confirming the central fatty component (Figure 3). The peripheral portion demonstrated mainly intermediate-to-low signal intensity on T1 weighted images and intermediate signal intensity on T2 weighted images. The peripheral soft tissue components of the mass showed heterogeneous enhancement after the administration of intravenous gadolinium-based contrast. There was no evidence of bony erosion, reactive oedema or remodelling in either CT or MRI scan (Figure 4).