Presentation
Two week history of left-sided pleuritic chest pain. On oral contraceptive pill. Elevated D-dimer. CTPA requested to exclude pulmonary embolism.
Patient Data
Age: 55 years
Gender: Female
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No pulmonary embolism identified in a good quality CT pulmonary angiogram.
An encapsulated ovoid fat-density lesion measuring 29 x 15 mm is seen within the left anterior pericardial fat, with surround inflammatory stranding. There is also a small left pleural effusion.
Case Discussion
Findings are consistent with pericardial fat necrosis. Small pleural effusion is present, which is a common associated feature. This rare, self-limiting condition symptomatically mimics pulmonary embolism, hence is often identified on CT pulmonary angiogram.