HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) CME Test (opens in a new window) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gaerte, S. C. Articles by Conces, D. J. Search for Related Content PubMed PubMed Citation Articles by Gaerte, S. C. Articles by Conces, D. J., Jr Related Collections Cardiac Radiology Chest Radiology Computed Tomography

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).

View larger version (108K): [in a new window]   Figure 1a.  Endobronchial hamartoma. (a) CT scan (mediastinal window) shows an endobronchial lesion containing fat in the right middle lobe bronchus (arrow). (b) CT scan obtained at the same level (lung window) shows postobstructive atelectasis in the middle lobe. (Case courtesy of H. Page McAdams, MD, Duke University Medical Center, Durham, NC.)

View larger version (58K): [in a new window]   Figure 1b.  Endobronchial hamartoma. (a) CT scan (mediastinal window) shows an endobronchial lesion containing fat in the right middle lobe bronchus (arrow). (b) CT scan obtained at the same level (lung window) shows postobstructive atelectasis in the middle lobe. (Case courtesy of H. Page McAdams, MD, Duke University Medical Center, Durham, NC.)

View larger version (104K): [in a new window]   Figure 2a.  Lipoid pneumonia. (a) Posteroanterior radiograph shows basilar airspace disease in a reticulonodular pattern. (b) CT scan (lung window) shows bilateral basilar ground-glass attenuation. The crazy-paving pattern of superimposed septal and interstitial centrilobular thickening is not clearly seen on this image. (c) CT scan (mediastinal window) allows confirmation of a low-attenuation consolidation (arrows).

View larger version (116K): [in a new window]   Figure 2b.  Lipoid pneumonia. (a) Posteroanterior radiograph shows basilar airspace disease in a reticulonodular pattern. (b) CT scan (lung window) shows bilateral basilar ground-glass attenuation. The crazy-paving pattern of superimposed septal and interstitial centrilobular thickening is not clearly seen on this image. (c) CT scan (mediastinal window) allows confirmation of a low-attenuation consolidation (arrows).

View larger version (117K): [in a new window]   Figure 2c.  Lipoid pneumonia. (a) Posteroanterior radiograph shows basilar airspace disease in a reticulonodular pattern. (b) CT scan (lung window) shows bilateral basilar ground-glass attenuation. The crazy-paving pattern of superimposed septal and interstitial centrilobular thickening is not clearly seen on this image. (c) CT scan (mediastinal window) allows confirmation of a low-attenuation consolidation (arrows).

View larger version (116K): [in a new window]   Figure 3a.  Parenchymal hamartoma. (a) CT scan shows a solitary pulmonary nodule containing a focus of low attenuation. (b) At further evaluation of the CT scan, the area of low attenuation is identified as fat (-41 HU), a finding that is consistent with a hamartoma.

View larger version (118K): [in a new window]   Figure 3b.  Parenchymal hamartoma. (a) CT scan shows a solitary pulmonary nodule containing a focus of low attenuation. (b) At further evaluation of the CT scan, the area of low attenuation is identified as fat (-41 HU), a finding that is consistent with a hamartoma.

View larger version (159K): [in a new window]   Figure 4a.  Mediastinal lipoma. (a) Posteroanterior chest radiograph shows a lobulated mass in the right paratracheal region. (b) CT scan shows a well-demarcated fatty mass surrounding the right brachiocephalic artery. (c, d) Coronal T1-weighted MR images (repetition time msec/echo time msec = 451/12) further show the fatty nature of the lesion. (Case courtesy of Charles S. White, MD, University of Maryland, Baltimore.)

View larger version (164K): [in a new window]   Figure 4b.  Mediastinal lipoma. (a) Posteroanterior chest radiograph shows a lobulated mass in the right paratracheal region. (b) CT scan shows a well-demarcated fatty mass surrounding the right brachiocephalic artery. (c, d) Coronal T1-weighted MR images (repetition time msec/echo time msec = 451/12) further show the fatty nature of the lesion. (Case courtesy of Charles S. White, MD, University of Maryland, Baltimore.)

View larger version (87K): [in a new window]   Figure 4c.  Mediastinal lipoma. (a) Posteroanterior chest radiograph shows a lobulated mass in the right paratracheal region. (b) CT scan shows a well-demarcated fatty mass surrounding the right brachiocephalic artery. (c, d) Coronal T1-weighted MR images (repetition time msec/echo time msec = 451/12) further show the fatty nature of the lesion. (Case courtesy of Charles S. White, MD, University of Maryland, Baltimore.)

View larger version (92K): [in a new window]   Figure 4d.  Mediastinal lipoma. (a) Posteroanterior chest radiograph shows a lobulated mass in the right paratracheal region. (b) CT scan shows a well-demarcated fatty mass surrounding the right brachiocephalic artery. (c, d) Coronal T1-weighted MR images (repetition time msec/echo time msec = 451/12) further show the fatty nature of the lesion. (Case courtesy of Charles S. White, MD, University of Maryland, Baltimore.)

View larger version (95K): [in a new window]   Figure 5a.  Mediastinal lipomatosis. Initial chest radiographs (not shown) demonstrated upper mediastinal widening with soft-tissue opacity at the level of the anteroposterior window. (a) CT scan (mediastinal window) shows a fatty lesion with mass effect on the superior vena cava and on the azygos vein (arrow). (b) CT scan (lung window) shows pulmonary fibrosis, which prompted the patient’s treatment with steroids.

View larger version (105K): [in a new window]   Figure 5b.  Mediastinal lipomatosis. Initial chest radiographs (not shown) demonstrated upper mediastinal widening with soft-tissue opacity at the level of the anteroposterior window. (a) CT scan (mediastinal window) shows a fatty lesion with mass effect on the superior vena cava and on the azygos vein (arrow). (b) CT scan (lung window) shows pulmonary fibrosis, which prompted the patient’s treatment with steroids.

View larger version (121K): [in a new window]   Figure 6.  Mature teratoma. CT scan shows a cystic mass with soft-tissue, fluid (arrow), fat (arrowheads), and calcium attenuation.

View larger version (99K): [in a new window]   Figure 7.  Teratocarcinoma. CT scan shows a lobulated mass with soft-tissue (curved arrow) and fat (straight arrow) attenuation. No calcifications were identified. The irregular margins of the mass with respect to lung parenchyma suggest local invasion, consistent with a malignant germ cell neoplasm.

View larger version (121K): [in a new window]   Figure 8a.  Lipoblastoma in a 7-year-old patient. (a) CT scan shows a heterogeneous fat-attenuation lesion at the thoracic inlet, a finding that is virtually diagnostic for a lipoblastoma. (b, c) Axial fast spin-echo T2-weighted (5,500/108) MR image (b) and coronal T1-weighted (500/14) MR image (c) show characteristic intratumoral streaks and whorls due to the tumor’s fibrovascular network. (Case courtesy of Mark J. Kransdorf, MD, Mayo Clinic, Jacksonville, Fla.)

View larger version (133K): [in a new window]   Figure 8b.  Lipoblastoma in a 7-year-old patient. (a) CT scan shows a heterogeneous fat-attenuation lesion at the thoracic inlet, a finding that is virtually diagnostic for a lipoblastoma. (b, c) Axial fast spin-echo T2-weighted (5,500/108) MR image (b) and coronal T1-weighted (500/14) MR image (c) show characteristic intratumoral streaks and whorls due to the tumor’s fibrovascular network. (Case courtesy of Mark J. Kransdorf, MD, Mayo Clinic, Jacksonville, Fla.)

View larger version (136K): [in a new window]   Figure 8c.  Lipoblastoma in a 7-year-old patient. (a) CT scan shows a heterogeneous fat-attenuation lesion at the thoracic inlet, a finding that is virtually diagnostic for a lipoblastoma. (b, c) Axial fast spin-echo T2-weighted (5,500/108) MR image (b) and coronal T1-weighted (500/14) MR image (c) show characteristic intratumoral streaks and whorls due to the tumor’s fibrovascular network. (Case courtesy of Mark J. Kransdorf, MD, Mayo Clinic, Jacksonville, Fla.)

View larger version (90K): [in a new window]   Figure 9.  Subpericardial lipoma in a 28-year-old man with ventricular tachycardia. CT scan shows a large, fat-attenuation lesion that surrounds and elevates the left anterior descending artery, a finding that is consistent with a subpericardial lipoma.

View larger version (107K): [in a new window]   Figure 10.  Cardiac lipoma. CT scan shows a well-defined focal fat-containing lesion (arrow) along the right atrial wall.

View larger version (142K): [in a new window]   Figure 11a.  Well-differentiated cardiac liposarcoma. Coronal T1-weighted (1,068/25) MR image (a) and axial T2-weighted (4,000/140) MR image (b) show a lobulated high-signal-intensity mass along the right border of the heart. (Case courtesy of Mark J. Kransdorf, MD, Mayo Clinic, Jacksonville, Fla.)

View larger version (134K): [in a new window]   Figure 11b.  Well-differentiated cardiac liposarcoma. Coronal T1-weighted (1,068/25) MR image (a) and axial T2-weighted (4,000/140) MR image (b) show a lobulated high-signal-intensity mass along the right border of the heart. (Case courtesy of Mark J. Kransdorf, MD, Mayo Clinic, Jacksonville, Fla.)

View larger version (77K): [in a new window]   Figure 12a.  Lipomatous hypertrophy of the interatrial septum. (a) CT scan shows a smooth, well-marginated fat-containing lesion in the interatrial septum. (b) Axial T1-weighted MR image obtained in a different patient shows the characteristic dumbbell shape of the lesion with sparing of the oval fossa (arrow).

View larger version (158K): [in a new window]   Figure 12b.  Lipomatous hypertrophy of the interatrial septum. (a) CT scan shows a smooth, well-marginated fat-containing lesion in the interatrial septum. (b) Axial T1-weighted MR image obtained in a different patient shows the characteristic dumbbell shape of the lesion with sparing of the oval fossa (arrow).

View larger version (122K): [in a new window]   Figure 13a.  Arrhythmogenic right ventricular dysplasia in a 24-year-old woman with recurrent ventricular tachycardia. (a) Axial fast spin-echo inversion recovery T2-weighted MR image shows that the apical portion of the right ventricular myocardium is replaced by fat (arrows). The more proximal right ventricular myocardium is normal (arrowheads). (b, c) End-systolic (b) and end-diastolic (c) cine MR images obtained at the same level as a show that the apical right ventricular myocardium is akinetic and fails to thicken normally. (Case courtesy of David A. Lynch, MD, University of Colorado Health Sciences Center, Denver.)

View larger version (65K): [in a new window]   Figure 13b.  Arrhythmogenic right ventricular dysplasia in a 24-year-old woman with recurrent ventricular tachycardia. (a) Axial fast spin-echo inversion recovery T2-weighted MR image shows that the apical portion of the right ventricular myocardium is replaced by fat (arrows). The more proximal right ventricular myocardium is normal (arrowheads). (b, c) End-systolic (b) and end-diastolic (c) cine MR images obtained at the same level as a show that the apical right ventricular myocardium is akinetic and fails to thicken normally. (Case courtesy of David A. Lynch, MD, University of Colorado Health Sciences Center, Denver.)

View larger version (66K): [in a new window]   Figure 13c.  Arrhythmogenic right ventricular dysplasia in a 24-year-old woman with recurrent ventricular tachycardia. (a) Axial fast spin-echo inversion recovery T2-weighted MR image shows that the apical portion of the right ventricular myocardium is replaced by fat (arrows). The more proximal right ventricular myocardium is normal (arrowheads). (b, c) End-systolic (b) and end-diastolic (c) cine MR images obtained at the same level as a show that the apical right ventricular myocardium is akinetic and fails to thicken normally. (Case courtesy of David A. Lynch, MD, University of Colorado Health Sciences Center, Denver.)

View larger version (140K): [in a new window]   Figure 14a.  Pleural lipoma. (a) Posteroanterior radiograph shows a smoothly marginated mass in the right apex. (b, c) CT scans obtained with lung (b) and mediastinal (c) windowing show the mass with fat attenuation, a finding that is consistent with a pleural lipoma.

View larger version (99K): [in a new window]   Figure 14b.  Pleural lipoma. (a) Posteroanterior radiograph shows a smoothly marginated mass in the right apex. (b, c) CT scans obtained with lung (b) and mediastinal (c) windowing show the mass with fat attenuation, a finding that is consistent with a pleural lipoma.

View larger version (108K): [in a new window]   Figure 14c.  Pleural lipoma. (a) Posteroanterior radiograph shows a smoothly marginated mass in the right apex. (b, c) CT scans obtained with lung (b) and mediastinal (c) windowing show the mass with fat attenuation, a finding that is consistent with a pleural lipoma.

View larger version (127K): [in a new window]   Figure 15a.  Pleural lipoma. (a, b) Posteroanterior (a) and lateral (b) chest radiographs show soft-tissue increased opacity in the inferior right pleural space. (c) The low attenuation of the mass on this CT scan helps confirm the presence of fat. On more superior scans (not shown), there was compressive atelectasis of the right lower lobe. (Case courtesy of James Pike, MD, Methodist Hospital, Indianapolis, Ind.)

View larger version (146K): [in a new window]   Figure 15b.  Pleural lipoma. (a, b) Posteroanterior (a) and lateral (b) chest radiographs show soft-tissue increased opacity in the inferior right pleural space. (c) The low attenuation of the mass on this CT scan helps confirm the presence of fat. On more superior scans (not shown), there was compressive atelectasis of the right lower lobe. (Case courtesy of James Pike, MD, Methodist Hospital, Indianapolis, Ind.)

View larger version (136K): [in a new window]   Figure 15c.  Pleural lipoma. (a, b) Posteroanterior (a) and lateral (b) chest radiographs show soft-tissue increased opacity in the inferior right pleural space. (c) The low attenuation of the mass on this CT scan helps confirm the presence of fat. On more superior scans (not shown), there was compressive atelectasis of the right lower lobe. (Case courtesy of James Pike, MD, Methodist Hospital, Indianapolis, Ind.)

View larger version (43K): [in a new window]   Figure 16.  Cross-sectional drawing depicts the common locations of juxtacaval fat and of Morgagni, Bochdalek, and hiatal hernias. Arrow = juxtacaval fat, green = lumbar trigone (foramen of Bochdalek), pink = esophageal hiatus, yellow = foramen of Morgagni.

View larger version (129K): [in a new window]   Figure 17a.  Morgagni hernia. (a, b) Posteroanterior (a) and lateral (b) chest radiographs show a large round anterior right cardiophrenic mass. (c) CT scan shows a retrosternal hernia that includes the omentum and colon.

View larger version (125K): [in a new window]   Figure 17b.  Morgagni hernia. (a, b) Posteroanterior (a) and lateral (b) chest radiographs show a large round anterior right cardiophrenic mass. (c) CT scan shows a retrosternal hernia that includes the omentum and colon.

View larger version (141K): [in a new window]   Figure 17c.  Morgagni hernia. (a, b) Posteroanterior (a) and lateral (b) chest radiographs show a large round anterior right cardiophrenic mass. (c) CT scan shows a retrosternal hernia that includes the omentum and colon.

View larger version (79K): [in a new window]   Figure 18a.  Bochdalek hernia. (a) CT scan shows a posterior paraspinal fat-containing lesion (-91.5 HU). (b) Multiplanar reformatted image clearly depicts the diaphragmatic defect and fat herniation without organ entrapment.

View larger version (147K): [in a new window]   Figure 18b.  Bochdalek hernia. (a) CT scan shows a posterior paraspinal fat-containing lesion (-91.5 HU). (b) Multiplanar reformatted image clearly depicts the diaphragmatic defect and fat herniation without organ entrapment.

View larger version (151K): [in a new window]   Figure 19a.  Hiatal hernia. (a) CT scan of the abdomen shows severe widening of the esophageal hiatus, with cephalic herniation of the abdominal contents. (b) Chest CT scan shows herniation of the stomach and of the bowel posterior to the heart.

View larger version (115K): [in a new window]   Figure 19b.  Hiatal hernia. (a) CT scan of the abdomen shows severe widening of the esophageal hiatus, with cephalic herniation of the abdominal contents. (b) Chest CT scan shows herniation of the stomach and of the bowel posterior to the heart.

View larger version (129K): [in a new window]   Figure 20.  Juxtacaval fat. CT scan shows a fat-containing lesion (-90 HU) that appears to be within the lumen of the IVC near the hepatic vein confluence. Continuity between the juxtacaval fat (arrowhead) and paraesophageal fat (arrow) can often be seen.