Pericardial fat pads

Case contributed by Dr Salman S. Albakheet

Presentation

Pre-employment check up.

Patient Data

Age: 30 years
Gender: Male

Chest radiograph

X-ray

Both lungs are generally clear. Both costophrenic recesses are clear. Straightening of both heart borders is noted with prominent right pericardial fat pad . No evidence of pneumothorax on either side. Visualized bony skeleton is unremarkable. 

Non enhanced chest CT scan

CT

Increased amount of fat in right as well as left cardiophrenic regions. A few flecks of calcifications are also appreciable in the pericardial fat. A few subcentimeter insignificant mediastinal lymph nodes are seen. A few subsegmental atelectatic bands are seen in left lower lobe. No suspicious pulmonary mass or nodularity is seen. No pleural/pericardial effusion or pneumothorax/pneumomediastinum is seen. Morphology of the rib cage is unremarkable. 

Case Discussion

Main differential diagnoses for the chest radiograph is right pericardial fat pad or right pericardial cyst.

The chest CT scan confirms the right sided pericardial fat pad and obviously detects the left pericardial fat pad, which was not clearly seen in the radiograph.

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