Vagal Paraganglioma

•  Also known as glomus vagale paraganglioma, vagal body tumor, vagle chemodectoma, glomus vagale 
•  Benign tumor arising from neural crest cells of the nodose ganglia of the vagus nerve
•  Look for enhancement on CT with contrast and "salt and pepper" appearance on T1 MR
•  Arises 1-2 cm below the jugular foramen and can displace fat anteriorly and the ICA anteromedially
•  Large at presentation (2-8 cm) with clear margination; spreads most commonly caudally towards the carotid biforcation or cranially to the jugular foramen
•  On CT: muscle density with non-contrast; intense enhancement with contrast
•  On MR: "pepper" (black dots) and "salt" appearance (white dots - uncommon) on T1, hyperintense and good spread definitinon on post-contrast T1
•  Occurs most commonly btween ages 40-60 with a 1:3 male to female predominance