Fat collection related to the intrahepatic inferior vena cava on CT.

Hines, J.; Katz, D S; Goffner, Lori; Rubin, Geoffrey D.

doi:10.2214/ajr.172.2.9930793

Cited by 20 publications

(12 citation statements)

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“…Based on our experience and that of others, 2,4 the identification of pericaval fat is almost always a normal finding or a variant of no clinical significance and is not associated with caval obstruction. In very select cases, there may be an association (as appears to be present in the patient reported by Chou et al l ) with shrinkage of the right hepatic lobe, leading to rightward tilting of the IVC, which provides a space between the IVC and the diaphragm for pericaval fat to collect.…”

supporting

confidence: 62%

“…As shown by several groups, including our own, this``lipoma'' is not fat within the IVC but is actually a collection of fat that is adjacent to but not within the lumen of the intrahepatic IVC. 2À4 Chou et al 1 cite the paper by Miyake et al 2 and correctly note that``a localized fat collection adjacent to the intrahepatic portion of the IVC is a normal variation on CT,'' 1,2 but everywhere else in their manuscript incorrectly refer to this entity as a``lipoma'' of the IVC and discuss it as if it is intraluminal.…”

mentioning

confidence: 99%

“…2,3 These fat collections have a unique appearance and should not be confused with other rare fat-containing lesions in or around the IVC. Additionally and most recently, a report by Ryan and Atri 4 documents the disappearance of these fat collections on follow-up helical CT scans obtained with identical imaging parameters in 3 patients.…”

mentioning

confidence: 99%

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“Lipoma” of the inferior vena cava is actually a pericaval fat collection

Katz¹,

Goffner²

2001

J of Clinical Ultrasound

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supporting

confidence: 62%

mentioning

confidence: 99%

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“Lipoma” of the inferior vena cava is actually a pericaval fat collection

Katz¹,

Goffner²

2001

J of Clinical Ultrasound

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“…Some cases of a lipoma projecting into the inferior vena cava (IVC), brachiocephalic vein, femoral vein and rarely into the superior vena cava (SVC) have been described previously [1][2][3]. We report a case of intravascular lipoma of the SVC in a patient without any signs or symptoms directly correlated with the tumor.…”

Section: Discussionmentioning

confidence: 99%

Intravascular lipoma of the superior vena cava

et al. 2011

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A 63-year-old man presented to the emergency department (ED) with left-sided abdomen pain. The patient reported a 5-day history of pain under the right shoulder blade and in the lumbar region, associated with constipation, but not with vomiting, diarrhea or any change in urination. The patient was taking prescribed medications: sennonides and rifaximin that had solved the constipation, but had not completely relieved the abdominal pain. His past medical history was significant for an appendectomy many years prior. He denied having any prior medical problems or allergies. On physical examination, he was oriented, alert, comfortable and in no acute distress. The vital signs were: heart rate of 90 beats/min., blood pressure 130/80 mmHg, respiratory rate 16 breaths/min, and temperature 35.8°C. The cardiovascular and respiratory examinations were unremarkable. The abdomen was soft, but the patient had tenderness in the epigastric region and in the right hypochondrium with guarding, and a mildly positive Murphy's sign. No rebound tenderness, tenderness at McBurney's point, palpable masses or abnormal pulsations was noted. Digital rectal examination was normal. On auscultation, normal bowel sounds were heard. The genitourinary examination was normal. Laboratory analysis revealed a lipase level of 225 U/L (range 6-50 U/L), amylase level of 93 U/L (range 13-53 U/L) and blood glucose level of 146 mg/dL (range 70-110 mg/dL). The serum blood urea nitrogen, creatinine, liver function tests, albumin, electrolytes, lactate dehydrogenase level and complete blood count (CBC) were normal. Coagulation studies, including prothrombin time, activated partial thromboplastin time and serum fibrinogen, were unremarkable. A chest and abdomen radiographs and an abdominal ultrasonography were performed, but all of them were unrevealing. An electrocardiogram demonstrated rapid atrial fibrillation without any acute injury pattern. A thoracoabdominal computed tomography (CT scan) showed a superior vena caval (SVC) filling defect with a subtotal occlusion that extended into the right atrium, like the suprahepatic IVC, with a dishomogeneous aspect. A partial filling defect was also noted at the level of the portal vein, extended up to the left portal vein and the superior mesenteric vein. The interpretations suggested a significant vascular thrombosis. The CT images also revealed gastric walls' thickening. Anticoagulant therapy was started, and the patient was admitted to an internal medicine ward. Laboratory analysis was ordered to re-evaluate the CBC and the chemistry panel, to monitor the coagulation profile and the urine analysis, to perform a screening for pro-thrombotic states (with homocysteine blood level test, the protein C and protein S test and the test for anti-cardiolipin antibodies) and to control tumor markers (with PSA test and CA 19-9 and CEA tumor markers tests) on the possibility that the thrombosis was a paraneoplastic syndrome. The lipase level was 72 U/L, the gamma-glutamyltranspeptidase (GGT) level was 126 U/L (range 10-4...

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“…TARTIŞMA VKİ'nin intrahepatik segmenti ile ilişkili fokal yağ dokusu koleksiyonu ve ÇKBT bulguları literatürde az sayıda olup, toplam 45 hasta bildirilmiştir. [1][2][3][4][5][6] Hastaların 24'ünde KKH veya siroz zemininde hepatoselüler karsinom (HSK) varlığı mevcuttur. [1][2][3][4][5] HSK'ya bağlı olarak özellikle karaciğerde gelişen anatomik distorsiyonun, VKİ'nin diyaframdan geçişi düzeyinde yapısal deviasyon ve yağ dokunun invajinasyonu sonucu KKH ile ilişkili olduğu düşü-nülmektedir.…”

Section: Olgu Sunumuunclassified