CHEST RADIOLOGY


Case 3:
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A 32 year old male presented with dry cough and chest discomfort of 8 months duration. His blood parameters and ECG were normal. Following a chest radiograph, an MRI study of the chest was later performed.
What is the diagnosis ?

 




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Answer :

MRI Findings :

Study revealed a large hyperintense lesion on T1WI filling almost the entire hemithorax, and extending into the superior mediastinum and right hemithorax. The left lung was compressed. Shift of mediastinal structures was noted. The left hemidiaphragm was displaced downwards. A few septae were seen within the lesion, no heterogenous areas were noted. This case was reported as thoracic lipomatosis. Possibility of liposarcoma was also considered in the differential diagnosis.
The patient was operated and the diagnosis of lipomatosis was confirmed at surgery.

Diagnosis :

Thoracic Lipomatosis

Brief Discussion :

Thoracic lipomatosis is a benign condition characterised by accumalation of uncapsulated fat within the mediastinum which distorts the mediastinum silhouette to verying degrees. Less commonly, it accumalates in the para spinal areas or near the cardiophrenic angles.Thoracic lipomatosis is usually not associated with obesity or Cushing's syndrome. The cause in this patient was not determined and was probably congenital / developmental in nature.

Contribution : Dr. Deepak Patkar, MRI Scan Centre, Nanavati Hospital, Mumbai.