A mediastinal lipoma is a benign fat-containing mediastinal lesion.
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Pathology
Similar to lipomas elsewhere and except in rare situations comprise of mature adipocytes. They can be variable in size. They are usually seen as an encapsulated mass with homogeneous fat attenuation. These lesions occur most commonly in the anterior mediastinum 2.
Differential diagnosis
On imaging possible differential considerations include
- thymolipoma - centered on the thymus
- mediastinal liposarcoma - can appear more infiltrative/invasive and less homogenous
- mediastinal lipomatosis - fatty tissue but usually diffuse and not encapsulated
- mediastinal germ cell tumor / mediastinal teratoma - usually contains other elements in addition to fat
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