CT
Axial C+ CTPA
Axial lung window
Coronal C+ CTPA
Sagittal C+ CTPA
The left epicardial fat is abnormally stranded and contains an encapsulated 4 cm ovoid fatty lesion at its lateral margin. A cluster of reactive lymph nodes are seen inferior to this lesion. A small left pleural effusion is present along with minor basal atelectasis. No pulmonary embolus seen. Absent spleen.