Correct!
4. The abdominal CT shows a vascularized right base mass
The abdominal CT shows a mass with broad contact with the right posterior chest wall, clearly containing some enhancing septae-like vascularity. The lesion is complex and vascularized and therefore does not represent simple right pleural liquid. While the mass does contact a significant portion of the right chest wall, there is no evidence of rib destruction or chest wall invasion. The mass does contact a portion of the posterior mediastinum (along the right aspect of the thoracic vertebral bodies), but the majority of the mass is centered more directly posteriorly, not within the typical boundaries of the posterior mediastinum. The mass is in a position within the thorax that is often affected by diaphragmatic defects that allow intrathoracic herniation of subdiaphragmatic contents. However, the mass is an abnormal finding and does not represent intrathoracic herniation of an otherwise normal abdominal or retroperitoneal organ, and no diaphragmatic defect is evident.
Clinical Course: Following discovery of the mass at abdominal CT scanning, the patient was questioned regarding possible symptoms that could be related to the mass, but she denied night sweats, cough, dyspnea, weight loss, palpitations, hemoptysis, and chest pain. At abdominal CT, a small area of heterogeneous pancreatic enhancement was seen, for which MR (Figure 3) evaluation was suggested.
Figure 3. MR imaging using steady-state free precession imaging (A-C), diffusion-weighted imaging (D), T2-weighted imaging with fat saturation (a fluid-sensitive sequence) (E), unenhanced (F) and enhanced (G-I) 3D fast spoiled gradient echo imaging shows the inhomogeneous mass in the right costophrenic angle.
Which of the following regarding this MR examination is correct? (Click on the correct answer to proceed to the fourth of nine panels)