CTICasesIntrapericardial Mediastinal Paraganglioma
Imaging findings
Chest CT reveals a well-defined, low-attenuation subcarinal mass located within the middle mediastinum and extending into the pericardial space. The mass displays a classic salt-and-pepper appearance with intense, hypervascular peripheral arterial enhancement and has a small claw of tissue extending directly between the aortic root and the pulmonary artery.
Key takeaways
Mediastinal paragangliomas are rare, highly vascular neuroendocrine tumors that arise from paraganglion cells. Because they typically originate adjacent to the coronary arteries and parasitize their blood supply, they are almost always located within the middle mediastinum or intrapericardial space. While they can be mistaken for simple cystic lesions or bronchogenic cysts on cardiac MRI due to their low attenuation and internal heterogeneity, the key CT diagnostic feature is intense, rapid arterial enhancement.
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