Primary Paratracheal Leiomyoma: Increased Preoperative Diagnostic Specificity With Magnetic Resonance Imaging Marie-Hélène Levesque, MD, Omonigho Aisagbonhi,

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Primary Paratracheal Leiomyoma: Increased Preoperative Diagnostic Specificity With Magnetic Resonance Imaging Marie-Hélène Levesque, MD, Omonigho Aisagbonhi, MD, PhD, Subba Digumarthy, MD, Cameron D. Wright, MD, Jeanne B. Ackman, MD The Annals of Thoracic Surgery Volume 102, Issue 2, Pages e151-e154 (August 2016) DOI: 10.1016/j.athoracsur.2016.01.015 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Contrast-enhanced computed tomographic (CT) views of chest. (A) Well-circumscribed, ovoid, homogeneous attenuation, 81-HU right paratracheal mass, with mild mass effect on the superior vena cava and mildly increased 18-fluorodeoxyglucose uptake on positron emission tomography CT. (B). Differential diagnosis includes a hyperattenuating bronchogenic cyst and a solid lesion. The Annals of Thoracic Surgery 2016 102, e151-e154DOI: (10.1016/j.athoracsur.2016.01.015) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Thoracic MRI breath-hold. (A) Axial in-phase T1-weighted image. (B) Cardiac-gated double inversion recovery T2-weighted image. (C) Precontrast 3-dimensional ultrafast gradient echo fat-saturated, T1-weighted image. (D) Three-minute postcontrast 3-dimensional ultrafast gradient echo fat saturated, T1-weighted image. The mass is mildly T1-hypointense and T2-isointense to skeletal muscle, with maximal enhancement at 3 minutes. (MRI = magnetic resonance imaging.) The Annals of Thoracic Surgery 2016 102, e151-e154DOI: (10.1016/j.athoracsur.2016.01.015) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Photomicrographs of hematoxylin and eosin stained tissue revealing bland, monomorphic spindle cells with blunt-ended nuclei arranged in interlacing fascicles, with eosinophilic cytoplasm and no nuclear atypia or mitoses. (A) Low-power view (×10). (B) High-power view (×40). The cells stain strongly and diffusely positive for desmin (C) and only focally for S100 (D). The Annals of Thoracic Surgery 2016 102, e151-e154DOI: (10.1016/j.athoracsur.2016.01.015) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions