Presentation
Incidental finding on a chest radiograph for investigation of cough.
Patient Data
Subtle mass projected over the mid right lung with the typical appearance of a pleurally-based lesion ie inferior border is well-defined but upper border is indistinct.
Fat density mass of low HU density (-127) arising from the intercostal muscle, bulging into the thoracic cavity as a pleural mass. No bone erosion or rib separation.
T1 hyperintense mass arising from the intercostal muscle showing no enhancement following Gd injection and complete loss of signal on the fat suppressed sequence.
Case Discussion
Lipomas are common in the subcutaneous tissues but can also be seen in the peripheral muscles especially around the shoulder girdle. Deep muscle involvement such as an intercostal muscle is unusual and is associated with a higher risk of neoplasm (liposarcoma) hence MRI examination to exclude a solid enhancing component.
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