Correct!

4. Extramedullary hematopoiesis

Differential Diagnosis

The differential diagnostic gamut under consideration for this case is the posterior mediastinal mass. Differential diagnostic considerations for posterior mediastinal lesions include abnormalities arising from the thoracic spine (particularly soft tissue masses resulting from vertebral body osteomyelitis and metastatic disease, and paraspinal hematomas in patients with thoracic spine fractures), abnormalities of the esophagus (dilation, as occurs with achalasia, neoplasms, and esophageal duplication cysts), neurogenic tumors (such those derived from the sympathetic ganglion cells, including neuroblastomas in infants, ganglioneuroblastomas and ganglioneuromas in younger children and adolescents, and lesions derived from the nerve sheath, including schwannomas, neurofibromas, and malignant peripheral nerve sheath tumors), esophageal varices, lymphadenopathy, and extramedullary hematopoiesis. Rare lesions, such as tumors derived from the paraganglionic system (pheochromocytomas and paragangiomas) and thoracic meningoceles may cause posterior mediastinal masses. The low attenuation foci within the paraspinous masses in this patient narrows the differential diagnosis to extramedullary hematopoiesis- the other lesions mentioned generally do not present with intralesional fat.

References

1. Woo OH, Yong HS, Shin BK, Oh YW, Kim HK, Kang EY. Wide spectrum of thoracic neurogenic tumours: a pictorial review of CT and pathological findings. Br J Radiol 2008; 81(968):668-676.
2. Lonergan GJ, Schwab CM, Suarez ES, Carlson CL  Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. Radiographics 2002; 22(4):911-934.
3. Tanaka O, Kiryu T, Hirose Y, Iwata H, Hoshi H. Neurogenic tumors of the mediastinum and chest wall: MR imaging appearance. J Thorac Imaging 2005; 20(4):316-320.

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