Small paraaortic mass seen on prior chest CT. Further characterization. Again seen is a well-defined left paraortic lesion localized in the left retrocrural space at the level of T12 which is stable in size and morphology compared to the prior chest CT. Reference measurements are provided below. The lesion has well-defined countors and is in close proximity to the paravertebral neurovascular bundles. It demonstrates slightly hyperintense signal on T2-weighted imaging with mild restricted diffusion and heterogeneous, predominantly peripheral enhancement on the arterial phase which washes out on the delayed phases acquired. Preserved fat planes between the lesion and the adjacent descending thoracic aorta, left diaphragmatic crura and adjacent vertebral body. No signs of local invasion.No additional lesions are identified.The visualized portions of the mediastinum, pleura, lungs and chest wall are within normal limits, considering limitations of technique.INDEX LESION MEASUREMENTS (Current exam date/time: 11/4/2016 10:00:00)LEFT PARA-AORTIC LESION: 1.7 x 0.9 cm (Image 4, Series 401); 1.9 x 1.0 cm on prior (8/3/2016) (Image 61, Series 3).
Stable small left paraortic mass which demonstrates imaging features suggestive of a small peripheral neurogenic tumor such as schwannoma, neurofibroma or paraganglioma. No evidence of local invasion or aggressive features at this point of time. In the absence of comparison images and indeterminate nature of this lesion, consider imaging follow-up (Spine MRI) to ensure stability. 