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Citation:
Gaillard F, Baba Y, Weerakkody Y, et al. Paracaval lipoma. Reference article, Radiopaedia.org (Accessed on 09 Jun 2023) https://doi.org/10.53347/rID-6755
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 5.
Paracaval lipoma may be seen in up to 0.5% of CT examinations 1.
Associations
It may be seen in patients with cirrhosis 4.
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 2.
CT
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.
Ultrasound
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 9.
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On imaging consider
- 1. Han B, Im J, Jung J, Chung M, Yeon K. Pericaval Fat Collection That Mimics Thrombosis of the Inferior Vena Cava: Demonstration with Use of Multi-Directional Reformation CT. Radiology. 1997;203(1):105-8. doi:10.1148/radiology.203.1.9122375 - Pubmed
- 2. Kandpal H, Sharma R, Gamangatti S, Srivastava D, Vashisht S. Imaging the Inferior Vena Cava: A Road Less Traveled. Radiographics. 2008;28(3):669-89. doi:10.1148/rg.283075101 - Pubmed
- 3. Kaufman L, Yeh B, Breiman R, Joe B, Qayyum A, Coakley F. Inferior Vena Cava Filling Defects on CT and MRI. AJR Am J Roentgenol. 2005;185(3):717-26. doi:10.2214/ajr.185.3.01850717 - Pubmed
- 4. Smillie R, Shetty M, Boyer A, Madrazo B, Jafri S. Imaging Evaluation of the Inferior Vena Cava. Radiographics. 2015;35(2):578-92. doi:10.1148/rg.352140136 - Pubmed
- 5. Raju N & Austin J. Case 37: Juxtacaval Fat Collection--Mimic of Lipoma in the Subdiaphragmatic Inferior Vena Cava. Radiology. 2001;220(2):471-4. doi:10.1148/radiology.220.2.r01au12471 - Pubmed
- 6. Pan X, Saida Y, Kurosaki Y, Onaya H, Itai Y. Fatty Mass in the Inferior Vena Cava at CT: Lipoma or Normal Variant? Radiat Med. 1995;13(5):251-3. - Pubmed
- 7. Grassi R, Di Mizio R, Barberi A, Severini S, Del Vecchio A, Cappabianca S. Case Report. Ultrasound and CT Findings in Lipoma of the Inferior Vena Cava. Br J Radiol. 2002;75(889):69-71. doi:10.1259/bjr.75.889.750069 - Pubmed
- 8. Katz D & Goffner L. "Lipoma" of the Inferior Vena Cava is Actually a Pericaval Fat Collection. J Clin Ultrasound. 2002;30(1):57-8. doi:10.1002/jcu.10020 - Pubmed
- 9. Chou Y, Chiou H, Tiu C, Chiang J, Chang C, Yu C. Sonographic Appearance of Lipoma of the Inferior Vena Cava. J Clin Ultrasound. 2001;29(6):359-62. doi:10.1002/jcu.1049 - Pubmed
- 10. Greenhill M, Gnecco IV J, Ahmed I. Paracaval Lipoma: Case Study and Literature Review. Radiology Case Reports. 2019;14(4):518-20. doi:10.1016/j.radcr.2018.07.020 - Pubmed
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