Age / Sex : 65 / F

Ganglioneuroma

Discussion

Findings:

CT:

oblong
subtle low density lesion(compared with muscle) at both foramen of L4/5

- with extension to Lt psoas muscle
and iliacus muscle

- with subtle rim enhancement

- without bony involvement

MR:

oblong heterogeneous high SI lesion
on T2W1 and low SI on T1WI with subtle rim enhancement at

both foramen of L4/5  

- with extension to Lt psoas muscle and iliacus muscle

    -
with high SI lesion on DWI(high SI on ADC)

Differential
Diagnosis:

schwannoma, neurofibroma, meningioma

(lymphomas, chordomas, soft-tissue
sarcomas, Ewing’s sarcoma, osteosarcomas,
chondrosarcomas,

and bone metastases à involve, invade and erode bones)

Diagnosis:  

Ganglioneuroma

Discussion:

- Rare, benign, slow-growing, well
differentiated tumor

- Children and young adults under the age
of 30

 
rarely in those older than 60 years

- Slight female predominance (1.13 to 1.5 :
1)

- Any part of the sympathetic tissue exists
from the skull base to the pelvis, but mainly from

the paraspinal sympathetic chain ganglia

- Part of neuroblastic tumors, depending on
the degree of cellular and extracellular

maturation

- Neuroblastomas (most immature,
undifferentiated, and with the most malignant potential)

 
Ganglioneuroblastomas (intermediate malignant potential)

Ganglioneuromas
(fully differentiated, most benign)

- Most common sites

 : posterior mediastinum, adrenal gland, and in
the lumbar and pelvic retroperitoneal space

 : unusual, spermatic cord, heart, intestine,
and bone

- MRI

 : low SI on T1WI

 : heterogeneous high SI on T2WI

  à abundant
cellular and fibrous components and only a small amount of myxoid stroma

 : gradual increasing enhancement on dynamic
images

References:

1. Lonergan GJ, Schwab CM, Suarez ES, Carlson CL. Neuroblastoma, ganglioneuroblastoma,
and

ganglioneuroma:
radiologic-pathologic correlation. Radiographics. 2002 Jul-Aug;22(4):911-34

2. Duffy S, Jhaveri M, Scudierre J, Cochran E, Huckman M. MR imaging of a posterior mediastinal

ganglioneuroma: fat as a useful diagnostic sign. AJNR Am J Neuroradiol. 2005 Nov-

Dec;26(10):2658-62.

3.
Mardi
K, Thakur
RC, Biswas
B. Ganglioneuroma arising from the L5 nerve root: A rare case

Report: Asian J Neurosurg. 2015 Jul-Sep; 10(3);232–233.