179 Chest Wall Lipoma

CASE 179


image Clinical Presentation


Asymptomatic 91-year-old woman


image Radiologic Findings


Coned-down PA (Fig. 179.1A) and lateral (Fig. 179.1B) chest radiographs demonstrate a peripheral opacity in the right superior hemithorax that forms obtuse angles with the adjacent chest wall (Fig. 179.1A). There is discrepancy in margin visualization consistent with an extrapulmonary location. Contrast-enhanced chest CT (lung window, Fig. 179.1C; mediastinal window, Fig. 179.1D) shows a peripheral mass that forms at least one obtuse angle with the adjacent chest wall (Figs. 179.1C, 179.1D) and exhibits fat attenuation with scant thin linear soft-tissue elements (Fig. 179.1D). The mass is contiguous with subcutaneous fat attenuation tissue.



image


Fig. 179.1


image Diagnosis


Chest Wall Lipoma


image Differential Diagnosis


None


image Discussion


Background


Benign chest wall tumors may originate from blood vessels, nerves, bone, cartilage, or fat. The imaging manifestations of benign and malignant chest wall lesions overlap, but some entities have characteristic imaging features that allow a confident diagnosis. Lipomas represent the most common soft-tissue chest wall tumors. They are well-circumscribed, encapsulated masses of adipose tissue that may lie deep within the chest wall and/or protrude into the thorax, displacing the pleura, mimicking other benign or malignant pleural lesions.


Etiology


The etiology of chest wall lipomas is unknown.


Clinical Findings


Chest wall lipomas are typically incidental findings in asymptomatic patients. They occur most frequently in patients who are 50–70 years of age and are more common in obese individuals.


Imaging Findings


Chest Radiography

• Well-marginated ovoid or lens-shaped chest wall mass (Figs. 179.1A, 179.1B)


• Lesions may exhibit the incomplete border sign

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Jan 14, 2016 | Posted by in RESPIRATORY IMAGING | Comments Off on 179 Chest Wall Lipoma
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