In a large soup pot or Dutch oven, brown the Italian sausage over medium-high heat. Drain excess grease if necessary.

Add the diced onion to the pot and sauté for 3-4 minutes until translucent. Stir in the minced garlic and tomato paste, cooking for 1 more minute.

Pour in the chicken broth and the undrained diced tomatoes. Bring the soup to a gentle boil.

Stir in the fresh cheese tortellini and boil for exactly the time indicated on the package (usually about 3-4 minutes).

Reduce the heat to low. Stir in the heavy cream and fresh spinach, letting it simmer for 2 minutes until the spinach wilts.

Serve immediately with grated parmesan cheese and crusty bread.