Imaging appearance of neurogenic tumors
On imaging, peripheral nerve neurogenic tumors may appear as lobulated spherical or fusiform masses in the paraspinal region of the thorax, sometimes with a dumbbell configuration if there is extension into a neural foramen. A plexiform neurofibroma, pathognomonic for neurofibromatosis type 1 (NF1), usually involves an entire nerve trunk or plexus. Associated smooth pressure erosions of the adjacent inferior rib surfaces and vertebrae or enlargement of the neural foramina may also be seen. Neurogenic tumors that arise from the sympathetic ganglia tend to appear as vertically oriented, elongated paraspinal masses with tapered borders. On CT and MRI, fluid attenuation or signal intensity components owing to cystic change or necrosis, soft tissue attenuation or signal intensity components, fat attenuation or signal intensity components secondary to fatty degeneration, and very high attenuation or very low signal intensity calcification may be visualized