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Intrapericardial Paraganglioma

Imaging findings

MRI shows an avidly enhancing, hypervascular mediastinal mass in the AP window and superior pericardium with multiple flow voids (salt and pepper sign) and elevated dopamine, fed by coronary collaterals.

Key takeaways

Paragangliomas are neuroendocrine tumors that can arise in the chest. Within the pericardium, they are highly vascular and show characteristic T2 hyperintensity and flow voids (salt and pepper sign), often producing excess catecholamines or dopamine.

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