Epipericardial Fat Necrosis: Radiologic Diagnosis and Follow-Up

Ultrasonographic Findings of Epipericardial Fat Necrosis: A Case Report

“…(3,4,8). In most recent EFN cases, together with our patient's clinical presentation, radiologic examination and follow-up imaging may be sufficient to confirm the diagnosis, and conservative management is considered the treatment of choice (3,8). Therefore, it is important for the radiologists to know the radiologic characteristics of EFN for appropriate diagnosis, to avoid unnecessary surgery.…”

“…It presents with acute chest pain and can mimic serious diseases, such as acute myocardial infarction or pulmonary thromboembolism (2). Computed tomography (CT) characteristics of EFN are well described as the encapsulated fatty lesion with perilesional strands and thickening of adjacent pericardium in the epipericardial area (3). Magnetic resonance imaging (MRI) also might be helpful for distinguishing EFN from other causes of acute chest pain or fat-containing tumors (4).…”

“…For confirming the diagnosis, the involution of this lesion on follow-up is important. Serial CT or MRI is usually used for follow-up in the previous reports (3,4).…”

“…Perilesional mediastinal fat stranding and thickening of the adjacent pericardium may be observed as well (3,7). EFN may be identified by MRI as a fat containing soft tissue lesion with a peripheral rim and low signal central dot-and-line on the T1-and T2-weighted images.…”

An Often-Overlooked Etiology of Pleuritic Chest Pain

“…2 The triad of pleuritic chest pain, classic CT findings, and negative cardiopulmonary work-up is highly suggestive of EPFN. 3 Because of its selflimiting nature, the treatment is conservative management with NSAIDs. 4 Follow-up imaging is recommended to confirm resolution and exclude neoplastic diseases such as liposarcoma.…”