This document discusses and provides CT scan images of various fat-containing lesions that can occur in the chest, including hamartomas, lipomas, liposarcomas, teratomas, and hernias. CT scans are shown demonstrating solitary pulmonary nodules containing fat, well-demarcated fatty masses surrounding blood vessels, bilateral lung consolidations with low attenuation consistent with lipoid pneumonia, and fat-containing lesions associated with the heart, interatrial septum, lungs, and diaphragm. Location and imaging characteristics are described for each type of lesion.

1. 56Fat-Containing Lesions of the
Chest

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig C 56-1 Endobronchial hamartoma. CT scan
shows a fat-containing lesion in the right
middle lobe bronchus with postobstructive
atelectasis. (Case courtesy of H. Page
McAdams, M.D., Duke University Medical
Center, Durham, N.C.).59

4. • Fig C 56-2 Parenchymal hamartoma. CT scan
demonstrates a solitary pulmonary nodule
containing a focus of low attenuation.59

5. • Fig C 56-3 Lipoma. CT scan shows a well-
demarcated fatty mass surrounding the right
brachiocephalic artery.59

6. • Fig C 56-4 Lipoid pneumonia. CT scan shows
bilateral consolidation with low attenuation
(arrows).59

7. • Fig C 56-5 Lipomatosis. CT demonstrates a fatty
lesion with mass effect on the superior vena cava
and azygos vein. Initial chest radiographs
demonstrated upper mediastinal widening with
soft-tissue opacity at the level of the
aorticopulmonary window.59

8. • Fig C 56-6 Teratoma. CT scan shows a cystic
mass with soft tissue, fluid (arrow), fat
(arrowheads), and calcium attenuation.59

9. • Fig C 56-7 Lipoma. Large, fat-attenuation
lesion that surrounds and elevates the left
anterior descending artery, a finding
consistent with a subpericardial lipoma.59

10. • Fig C 56-8 Liposarcoma. Axial T1-weighted MR
image shows a lobulated highsignal-intensity
mass along the right border of the heart.
(Case courtesy of Mark J. Kransdorf, MD, Mayo
Clinic, Jacksonville, Fla.).59

11. • Fig C 56-9 Lipomatous hypertrophy of the
interatrial septum. CT scan shows the smooth,
well-marginated fat-containing lesion.59

12. • Fig C 56-10 Pleural lipoma. (A) CT scan with
mediastinal windowing shows a smoothly
marginated mass with fat attenuation in the
apex of the right lung. (B) In another patient,
there is an extensive mass of low attenuation
in the right lung. (B, courtesy of James Pike,
MD, Metholdist Hospital, Indianapolis, IN).59

13. • Fig C 56-11 Hiatal hernia. CT scan shows
herniation of the stomach and bowel
posterior to the heart.59

14. • Fig C 56-12 Morgagni hernia. CT scan shows a
retrosternal hernia that includes the omentum
and colon.59

15. • Fig C 56-13 Bochdalek hernia. CT scan shows a
posterior paraspinal fat-containing lesion.59

16. • Fig C 56-14 Juxtacaval fat. CT scan shows a fat-
containing lesion that appears to be within the lumen
of the IVC near the hepatic vein confluence. Continuity
between the juxtacaval fat (arrowhead) and
paraesophageal fat (arrow) can often be seen.59