Fat-containing lesions of the chest.
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.
Gaerte
Scott C
SC
Department of Radiology, Indiana University School of Medicine, Indiana University Hospital, Indianapolis, IN 46202-5253, USA. sgaerte@iupui.edu
Meyer
Cristopher A
CA
Winer-Muram
Helen T
HT
Tarver
Robert D
RD
Conces
Dewey J
DJ
D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D006222:Hamartoma / Q000000981:diagnostic imaging; D006548:Hernia, Diaphragmatic / Q000000981:diagnostic imaging; D006801:Humans; D008067:Lipoma / Q000000981:diagnostic imaging; D008080:Liposarcoma / Q000000981:diagnostic imaging; D008171:Lung Diseases / Q000000981:diagnostic imaging*; D018205:Neoplasms, Adipose Tissue / Q000000981:diagnostic imaging*; D010496:Pericardium; D011017:Pneumonia, Lipid / Q000000981:diagnostic imaging; D018202:Pulmonary Blastoma / Q000000981:diagnostic imaging; D011859:Radiography; D018243:Teratocarcinoma / Q000000981:diagnostic imaging; D013724:Teratoma / Q000000981:diagnostic imaging; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging*