Pericardial lipomas are slowly growing benign tumours of the pericardium that are asymptomatic unless large in size, where they can cause pressure symptoms.
Tends to be echogenic structure adjacent or inside the pericardium.
Seen as a fatty attenuating tumour that displays <0 HU density. No enhancement post-contrast administration. The lesion may not be well-circumscribed like other lipomas.
Exhibits bright signal on T1 and T2 with no contrast enhancement. Fat suppression techniques e.g. STIR, SPAIR and FAT SAT confirm the fatty contents.
Imaging differential considerations include
- pericardial lipoblastoma: can have a similar appearance but occurs in children <3 years of age
As a broader differential consider