Pleural lipoma
Updates to Article Attributes
A pleural lipoma is the most common benign soft tissue tumour of the pleura. These lesions are thought to originate from the submesothelial layers of the parietal pleura, extending into the subpleural, pleural, or extrapleural space. Pleural lipomas are encapsulated fatty tumors with a slow growth rate.1.
Clinical features
Normally asymptomatic and detected incidentally. In some cases it causes pleural irritation with an urge to cough. When large, it can cause chest heaviness and breathlesness.
Radiographic features
Plain radiography
- well defined, convex lesions forming obtuse angles with the pleura
- normally vertically orientated in relation to the chest wall
- no rib erosion
- appears denser than fat because of interface with air in the lung
Cross sectional imaging
- homogeneous fat density or fat signal intensity
- no enhancement
Management
The are thought to never transform into a sarcoma. Traditionally, management consisted of either doing nothing, or observation. Recently, it has been suggested that this stance should be reconsidered due to their potential to grow, and due to the advances in video-assisted thoracic surgery.2, 3-3.
Differential diagnosis
The principal differential diagnoses are those of single pleural masses. However fat containing lesions of the chest (e.g. hamartoma) should also be considered.
Extrapleural fat represents fat outside the parietal pleura. It is part of the loose connective tissue of the endothoracic fascia, most abundant along the posterolateral aspects of the 4th through 8th ribs. Extrapleural fat is typically bilateral, symmetricsymmetrical, and located along the midlateralmid-lateral chest wall.1
-<p>A <strong>pleural lipoma</strong> is the most common benign soft tissue tumour of the pleura. These lesions are thought to originate from the submesothelial layers of the parietal pleura, extending into the subpleural, pleural, or extrapleural space. Pleural lipomas are encapsulated fatty tumors with a slow growth rate.<sup>1</sup></p><h4>Clinical features</h4><p>Normally asymptomatic and detected incidentally. In some cases it causes pleural irritation with an urge to cough. When large, it can cause chest heaviness and breathlesness.</p><h4>Radiographic features</h4><h5>Plain radiography</h5><ul>- +<p>A <strong>pleural lipoma</strong> is the most common benign soft tissue tumour of the pleura. These lesions are thought to originate from the submesothelial layers of the parietal pleura, extending into the subpleural, pleural, or extrapleural space. Pleural lipomas are encapsulated fatty tumors with a slow growth rate<sup>1</sup>.</p><h4>Clinical features</h4><p>Normally asymptomatic and detected incidentally. In some cases it causes pleural irritation with an urge to cough. When large, it can cause chest heaviness and breathlesness.</p><h4>Radiographic features</h4><h5>Plain radiography</h5><ul>
-</ul><h4>Management</h4><p>The are thought to never transform into a sarcoma. Traditionally, management consisted of either doing nothing, or observation. Recently, it has been suggested that this stance should be reconsidered due to their potential to grow, and due to the advances in video-assisted thoracic surgery.<sup>2, 3</sup></p><h4>Differential diagnosis</h4><p>The principal differential diagnoses are those of <a href="/articles/differential-of-a-single-pleural-mass">single pleural masses</a>. However fat containing lesions of the chest (e.g. <a href="/articles/pulmonary-hamartoma-1">hamartoma)</a> should also be considered.</p><p><a href="/articles/extrapleural-fat">Extrapleural fat</a> represents fat outside the parietal pleura. It is part of the loose connective tissue of the endothoracic fascia, most abundant along the posterolateral aspects of the 4<sup>th</sup> through 8<sup>th</sup> ribs. Extrapleural fat is typically <em>bilateral, symmetric</em>, and located along the midlateral chest wall.<sup>1</sup> </p>- +</ul><h4>Management</h4><p>The are thought to never transform into a sarcoma. Traditionally, management consisted of either doing nothing, or observation. Recently, it has been suggested that this stance should be reconsidered due to their potential to grow, and due to the advances in video-assisted thoracic surgery <sup>2-3</sup>.</p><h4>Differential diagnosis</h4><p>The principal differential diagnoses are those of <a href="/articles/differential-of-a-single-pleural-based-mass">single pleural masses</a>. However fat containing lesions of the chest (e.g. <a href="/articles/pulmonary-hamartoma-1">hamartoma)</a> should also be considered.</p><p><a href="/articles/extrapleural-fat">Extrapleural fat</a> represents fat outside the parietal pleura. It is part of the loose connective tissue of the endothoracic fascia, most abundant along the posterolateral aspects of the 4<sup>th</sup> through 8<sup>th</sup> ribs. Extrapleural fat is typically <em>bilateral, symmetrical</em>, and located along the mid-lateral chest wall.<sup>1</sup> </p>
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