CT Evaluation of Enhancing Mediastinal Masses

The CT scans of 132 patients with mediastinal masses and CT scans from our teaching file were retrospectively reviewed to evaluate the role of contrast enhancement in limiting the differential diagnosis of a mediastinal mass. Ten patients with an enhancing mediastinal mass were found. Coupled with mass enhancement, location and hypertension were helpful in limiting the differential diagnosis. Four masses were of thyroid origin, and all were contiguous with neck thyroid. All patients with functioning paragangliomas were hypertensive and all intrapericardial enhancing masses were functioning paragangliomas. A normotensive patient had a nonfunctioning aortic body paraganglioma superiolateral to the aortic arch. An enhancing mass in a similar location in a hypertensive patient was a functioning paraganglioma. Castleman disease occurred posterior to the heart.