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Fat-containing Lesions of the Chest¹

¹ From the Department of Radiology, Indiana University School of Medicine, Indiana University Hospital, 550 N University Blvd, Indianapolis, IN 46202-5253. Presented as an education exhibit at the 2001 RSNA scientific assembly. Received February 1, 2002; revision requested March 26 and received May 22; accepted June 4. Address correspondence to S.C.G. (e-mail: scgaerte@iupui.edu).

Although most lesions that occur in the chest have a nonspecific soft-tissue appearance, fat-containing lesions are occasionally encountered at cross-sectional computed tomography (CT) or magnetic resonance imaging. The various fat-containing lesions of the chest include parenchymal and endobronchial lesions such as hamartoma, lipoid pneumonia, and lipoma. Endobronchial hamartoma usually appears at CT as a lesion with a smooth edge, focal collections of fat, or fat collections that alternate with foci of calcification. Mediastinal fat-containing lesions include germ cell neoplasms, thymolipomas, lipomas, and liposarcomas. The most frequent CT manifestation of the germ cell neoplasm teratoma is a heterogeneous mass with soft-tissue, fluid, fat, and calcium attenuation. Cardiac lesions with fat content include lipomatous hypertrophy of the interatrial septum and arrhythmogenic right ventricular dysplasia. Diagnosis of the former is made with CT when a smooth, nonenhancing, well-marginated fat-containing lesion is identified in the interatrial septum. Finally, fat may herniate into the chest at several characteristic locations. When such a lesion is identified, the time required for differential diagnosis is significantly reduced, often allowing a definitive radiologic diagnosis. Sagittal and coronal reformatted images can add valuable information by showing diaphragmatic defects and hernia contents.

Index Terms: Arrhythmogenic right ventricular dysplasia, 51.1959 • Fat, CT, **.1211²² • Fat, MR, **.1214 • Hamartoma, 60.314 • Heart, abnormalities • Heart, neoplasms, 51.312, 51.32 • Hernia, 71.152, 795.153, 795.154 • Lipoma and lipomatosis, 51.312, 51.59, 60.319 • Lung, infection, 60.21 • Lung neoplasms, 60.314 • Mediastinum, neoplasms, 67.315 • Pleura, neoplasms, 66.317

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