Differential Diagnosis of CT Images in Children with Neuroblastomas and Ganglioneuroblastomas

  • Zhuang, Bo (Department of Pediatric Surgery, Jining No.1 People's Hospital) ;
  • Lv, Deng-Kun (Department of Pediatric Surgery, Jining No.1 People's Hospital) ;
  • Gao, Si-Ju (Department of Pediatric Internal Medicine, Linyi People's Hospital) ;
  • Meng, Jing-Jing (Neonatal Ward, Jining No.1 People's Hospital)
  • Published : 2015.01.06


Objective: To investigate the differential features of CT images in children with neuroblastomas (N) and ganglioneuroblastomas (G). Materials and Methods: Clinical data of 12 children in group G and 15 in group N undergoing CT examination and definitely diagnosed by pathology were retrospectively analyzed. The focal conditions were observed and compared in the two groups, including location, size, boundaries, morphology, enhanced degree and mode, abdominal vascular involvement, presence or absence of spanning the midline, infiltration of peripheral organs, angiography manifestations in tumors or surroundings, presence or absence of calcification and vascular tumor emboli as well as metastases of distal organs and lymph nodes. Results: In group N, the incidence of tumors in the adrenal area was conspicuously higher than in group G (P<0.05), while that of tumors with regular morphology and clear boundaries was significantly lower than in group G (P<0.01); Angiography manifestation rate and incidences of vascular embedding, lymph node metastasis, infiltration and organic metastasis in group N were all markedly higher than in group G (P<0.05). There was no statistical significance between the two groups in terms of focal size, presence or absence of calcification and spanning the midline, and enhanced degree and mode, as well as vascular tumor emboli (P>0.05). Conclusions: Mostly located in adrenal areas and with vascular embedding as a primary manifestation, the neuroblastoma extremely readily metastases to lymph nodes and other organs as well as infiltrating local tissues, with dilation on angiography frequent in or around the tumors. With vascular displacement as a primary manifestation, ganglioneuroblastoma has a regular morphology and clear boundaries.


Neuroblastoma;ganglioneuroblastoma;CT images;lymph node metastasis;children


  1. Louis CU, Shohet JM (2014). Neuroblastoma: molecular pathogenesis and therapy. Annu Rev Med [Epub ahead of print].
  2. Morgenstern DA, Baruchel S, Irwin MS (2013). Current and future strategies for relapsed neuroblastoma: challenges on the road to precision therapy. J Pediatr Hematol Oncol, 35, 337-47.
  3. Nasseh H, Shahab E (2013). Retroperitoneal ganglioneuroma mimicking right adrenal mass. Urology, 82, e41-2.
  4. Otal P, Mezghani S, Hassissene S et al (2001). Imaging of retroperitoneal ganglioneuroma. Eur Radiol, 11, 940-5.
  5. Qin HY, Sun H, Wang X, et al (2013). Correlation between CT perfusion parameters and microvessel density and vascular endothelial growth factor in adrenal tumors. PLoS One, 8, e79911.
  6. Sharp SE, Parisi MT, Gelfand MJ, et al (2013). Functionalmetabolic imaging of neuroblastoma. Q J Nucl Med Mol Imaging, 57, 6-20.
  7. Sutton EJ, Tong RT, Gillis AM (2009). Decreased aortic growth and middle aortic syndrome in patients with neuroblastoma after radiation therapy. Pediatr Radiol, 39, 1194-202.
  8. Wang L, Che XJ, Wang N et al (2014). Regulatory network analysis of microRNAs and genes in neuroblastoma. Asian Pac J Cancer Prev, 15, 7645-52.
  9. Angelini P, Baruchel S, Marrano P, et al (2014). The neuroblastoma and ganglion components of nodular ganglioneuroblastoma are genetically similar: evidence against separate clonal origins. Mod Pathol [Epub ahead of print].
  10. Duijkers FA, Gaal J, Meijerink JP, et al (2012). High anaplastic lymphoma kinase immunohistochemical staining in neuroblastoma and ganglioneuroblastoma is an independent predictor of poor outcome. Am J Pathol, 180, 1223-31.
  11. Liu W, Zheng J, Li Q (2013). Application of imaging modalities for evaluating neuroblastoma. J Pediatr Endocrinol Metab, 26, 1015-20.
  12. Gheytanchi E, Mehrazma M, Madjd Z (2014). Expression of Ki-67, p53 and VEGF in pediatric neuroblastoma. Asian Pac J Cancer Prev, 15, 3065-70.
  13. Heczey A, Louis CU (2013). Advances in chimeric antigen receptor immunotherapy for neuroblastoma. Discov Med, 16, 287-94.
  14. Jay L, James A, Erie W (2006). Neuroblastoma. Pediatric Surgery. 6th ed. New York: Oxford University, 468-510.
  15. Keating JP (2005). Chronic diarrhea. Pediatr Rev, 26, 5-14.
  16. Kiyonari S, Kadomatsu K (2014). Neuroblastoma models for insights into tumorigenesis and new therapies. Expert Opin Drug Discov, [Epub ahead of print].
  17. Kubota M, Suita S, Tajiri T (2000). Analysis of the prognostic factors relating to better clinical outcome in ganglioneuroblastoma. J Pediatr Surg, 35, 92-5.

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