Which imaging findings are characteristic of primitive neuroectodermal tumor of the thoracopulmonary region (PNET)?

Updated: Dec 25, 2019
  • Author: Joseph F Tomashefski, Jr, MD; more...
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Answer

The most frequent finding on standard chest radiography is a unilateral chest wall mass. Pleural disease is characterized by fluid accumulation and/or pleural thickening by tumor. Associated pulmonary parenchymal disease is noted in some patients. [39] Chest CT scanning depicts a heterogeneous soft-tissue mass. [50]

On MRI, T2-weighted images tend to be bright and heterogeneous in signal intensity. Tumor heterogeneity due to hemorrhage and necrosis is also seen in the T1-weighted MRI, which usually has a signal intensity greater than skeletal muscle.

Both MRI and CT imaging may reveal chest wall and/or lung invasion. However, neither modality can reliably separate lung invasion from lung compression by the adjacent primary tumor. [50] Tumor calcification is rare. Metastatic disease has been reported in approximately 10% of patients at the time of presentation.

In one series, CT scanning was superior to MRI in detecting small pulmonary metastases. [50]


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