case_images: PMC10864141_01
case_images: A 63-year-old male with incidentally discovered mediastinal vascular malformation.. A. Chest CT images show widespread soft tissue lesions along the mediastinum, diaphragm, and abdomen. Non-contrast images (first column) show scattered calcifications (phleboliths) and interspersed fat. Post-contrast (acquired in the arterial phase) images (second column) do not show any arterial feeders.. B. Non-contrast, arterial, portal, and delayed phase (in order) abdominal CT images show gradual delayed enhancement.. C. The axial chest CT images demonstrate partial continuity of the lesions (delineated by the yellow dotted line) among the mediastinal compartments.. D. The sagittal reformatted images show potential continuity of the lesions (delineated by the yellow dotted line) between the mediastinum, diaphragm and the right retroperitoneal space.. E. On MRI, the lesion shows high signal intensity on fat-saturated T2 weighted images (first row) and intermediate signal intensity on T1 weighted images (second row). Upon contrast enhancement, this shows gradual delayed enhancement in arterial, portal, and delayed phase images (third row, in order).. F. The MR T2 weighted image shows a large draining vein into the inferior vena cava (arrows).
case_images: jksr-85-204-g001.jpg
case_images: PMC10864141_01_jksr-85-204-g001.jpg
case_images: F1
case_images: Contrast-enhanced chest CT revealed widespread soft-tissue density lesions along the mediastinum, diaphragm, and upper abdomen, engulfing adjacent organs (Fig. 1A). The lesion exhibited gradual delayed enhancement on multiphase abdominal CT, without feeding arteries (Fig. 1B). On axial (Fig. 1C) and sagittal reformatted (Fig. 1D) imaging, we suspected partial connectivity among the lesions located in each mediastinal compartment, diaphragm, and retroperitoneal space. T1-weighted images (Fig. 1E, second row). The lesion showed delayed enhancement, similar to the CT scan (Fig. 1E, third row), with no arterial feeders. T2-weighted imaging revealed a large draining vein into the inferior vena cava (IVC) (Fig. 1F).