Mediastinal lipoma

Case contributed by Assoc Prof Frank Gaillard

Presentation

Incidental finding on immigration CXR.

Patient Data

Age: 30 years
Gender: Male

Well defined relatively low attenuation anterior mediastinal mass. On the frontal projection the hilar vessels can be seen distinctly through the mass. 

Lateral chest radiograph confirms the presence of a mass in the anterior mediastinum.

Limited images of an MRI of the chest demonstrate the mass to be of fat density (confirmed on fat saturated sequences - not shown). 

Annotated images

A well circumscribed mass (yellow line) is present projecting to the right of the mediastinum. On the frontal chest x-ray the hilar vessels (red line) are seen projecting though it indicating the mass is not at the hilum itself (hilum overlay sign). On MRI the mass can be seen distinct from the normal mediastinal fat (blue arrows).

Case Discussion

Typical appearances of a fatty mass, followed for 15 years with no change, consistent with an incidental mediastinal lipoma. 

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