Diagnostics of Peripherally Located Intrathoracic Lipoma

Abstract

In the differential diagnosis of lipomas, fibromatous hamartoma, liposarcoma, fibrolipoma and teratoma may be mentioned as fat-containing lesions of peripheral localization. However, these lesions are different from lipomas in that they contain soft tissue components and are not homogeneous. Furthermore, they are much larger than lipomas, are infiltrative and their CT density is greater than -50 HU. Though it is emphsized that up to the present time surgery has been the gold standard method in the recognition and treatment, considering the risks of surgical procedures, we are of the opinion that diagnosis can be established and the follow-up can be managed with advanced radiological methods and that there is no necessity for invasive interventions especially in asymptomatic patients.

Giant Right Intrathoracic Myxoid Fusocellular Lipoma

“…Most of the aforementioned lesions present with inhomogeneous densities, which allows for an easy differential diagnosis. Malignant lesions often present with an infiltrative aspect, invading the surrounding structures [ 6 , 7 ]. However, even in the cases with a typical lipoma CT aspect, a malignant component is difficult to exclude (even on biopsy specimens), which is a plea for complete surgical removal of this kind of lesions [ 2 ].…”

“…However, even in the cases with a typical lipoma CT aspect, a malignant component is difficult to exclude (even on biopsy specimens), which is a plea for complete surgical removal of this kind of lesions [ 2 ]. For the lesions located near the diaphragm, diaphragmatic hernias and localized eventrations containing omentum, which is a fatty structure, must be also taken into consideration and excluded by careful 3D CT reconstructions or MRI examination [ 7 ].…”