CTICasesApical Schwannoma
Imaging findings
Chest CT and MRI in two patients show a large, well-defined mass in the apex of the lung/posterior chest wall. On CT, the masses are low-attenuation, mimicking a duplication cyst. MRI demonstrates intense T2 signal with internal heterogeneity, flow voids, and avid contrast enhancement. Histopathology confirms a benign schwannoma.
Key takeaways
Schwannomas are benign nerve sheath tumors that commonly arise from intercostal nerves in the posterior mediastinum or lung apex. Large schwannomas can exhibit low attenuation on CT due to myxoid degeneration or cystic changes, mimicking a bronchogenic or foregut cyst. MRI is helpful in demonstrating the classic features of nerve sheath tumors (such as intense T2 signal and target sign) to guide resection.
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