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Ganglioneuroma

Ganglioneuromas are fully differentiated neuronal tumours that do not contain immature elements 1. They tend to occur in the paediatric population and are often asymptomatic. Usually, patients are older than 10 years old, compared to neuroblastoma which occurs in patient younger than 3 years old.

Pathology

Pathologically, they are composed of ganglion cells, Schwann cells and fibrous tissue. They are neuroblastic tumours, i.e. arising from primitive cells of the sympathetic system.

Associations
Location

Can potentially occur anywhere along the peripheral autonomic ganglion sites. The posterior mediastinum one of the commonest locations (~ 40%). Occurrence in retroperitoneum, neck and adrenal gland is also relatively common.

Radiographic features

Lesions are generally well defined and can be quite large at presentation.

CT

Typically seen as well-circumscribed, solid, encapsulated masses. Tend to be iso to hypo-attenuating to muscle 8. May demonstrate calcifications (~ 20% 2,4)

MRI

Reported signal characteristics include

  • T1 - tends to have homogeneously low or intermediate signal
  • T2 - tends to have heterogenously intermediate or high signal
  • T1 C+ (Gd) - variable ranging from none to heterogenous enhancement
  • ADC - ADC values tend to be higher to that of a neuroblastoma 9

Differential diagnosis

The differential depends on location; for thoracic lesions, consider the differential for a posterior mediastinal mass.

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