Malignant versus benign paravertebral widening in children

Dorso-medial pleural reflection line anomalies occur in malignant tumours, neuroblastoma being the commonest one, in benign tumours, spinal inflammatory disorders and in cases of pseudotumours of different origin. The latter group comprises normal structure variants, malformations and acquired disease but also a small number of transitory or permanent lesions of uncertain or obscure origin. The radiological manifestations encountered are displacement, obliteration or blurring of the paraspinal contour, sometimes a frank paravertebral mass. Based on a case material consisting of 65 patients the importance of recognizing this feature is stressed. An approach to clinical and radiological diagnosis is discussed.