A Benign Cause of Widened Mediastinum: A Case of Mediastinal Lipomatosis

Idiopathic Mediastinal Lipomatosis Presenting as Pulmonary Embolism: A Rare Case Report.

“…In case of acute symptomatology, emergencies should be excluded first. These include aortic dissection, esophageal rupture, trauma, haemorrhage or mediastinitis [5]. In our patient's case, left lower lobe segmental lung collapse was suggestive of pulmonary embolism.…”

“…Our patient had acute chest pain with dorsal irradiation. The physical examination can be quite normal, as it can regain dyspnea, obesity and signs associated with Cushing's syndrome [5]. Our patient had no evidence of obesity or steroid excess.…”

“…Mediastinal lipomatosis is usually asymptomatic and fortuitously discovered. However, it can become compressive and cause cough, dyspnea even respiratory distress, chest pain, dysphagia, cardiac arrhythmia or superior vena cava syndrome [2][3][4][5]. Our patient had acute chest pain with dorsal irradiation.…”

“…The examination of choice is computed tomography or, less often, MRI, it allows not only to confirm the diagnosis of mediastinal lipomatosis but also to define its extent. Adipose tissue can extend from the upper mediastinum to the diaphragm and can involve the heart and lungs [5]. CT is also useful for eliminating a vascular or tissue cause that may require a biopsy.…”

“…Mediastinal lipomatosis is usually asymptomatic and no treatment is necessary. In the case the patient is obese, weight loss is strongly recommended [5]. Tapering off steroids is usually needed in steroid induced lipomatosis [3].…”