Paracaval lipoma

Last revised by Andrea Molinari on 19 Nov 2023

A paracaval lipoma (also known as juxtacaval fat collection or pseudolipoma of the inferior vena cava) refers to an apparent protrusion of paracaval fat into the inferior vena cava (IVC) and is commonly visible on CT; some believe it to be a normal anatomic variant 1

Paracaval lipoma may be seen in up to 0.5% of CT examinations 2.

It may be seen in patients with cirrhosis 3

The paracaval lipoma appearance is thought to be due to volume averaging through inwards and upwards indrawing of the posteromedial wall of the inferior vena cava as a result of negative pressure created within the thorax on inspiration 4.

Paracaval lipoma occurs at the medial aspect of the intrahepatic portion of the inferior vena cava (IVC) above the caudate lobe and represents pericaval fat appearing to invaginate into the inferior vena cava. Attenuation values is measure usually falls the in the compatible with macroscopic fat. 

In some situations may be seen as a echogenic, homogeneous nodule in the hepatic segment of the IVC at its junction with the right atrium 5

On imaging consider

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