Fatty mediastinal masses (differential)

Last revised by Francis Deng on 30 Dec 2020

Fatty mediastinal masses are relatively uncommon, and the differential diagnosis is brief, including 1-4:

  • lipoma
  • liposarcoma
  • thymolipoma
  • benign mature teratoma
  • lipoblastoma
  • extravasation of lipid-rich hyperalimentation fluid 3
  • fibrofatty replacement of the central portion of mediastinal lymph nodes can be seen as the sequelae of previous inflammatory disease 3
  • pulmonary hamartoma may abut the mediastinum
  • neurofibroma can have fat attenuation on CT, however the fatty changes in neurofibroma are rarely observed.5

Additionally a number of conditions can result in accumulation or herniation of normal fat into the mediastinum, mimicking a mass.

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