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Mediastinal Fat Necrosis post-Heart Transplant

Imaging findings

Serial CT scans following a heart transplant and subsequent sternal wound infection show evolution of an inflamed anterior mediastinal fat pad into a well-circumscribed, fatty mass with linear rim calcification, representing fat necrosis.

Key takeaways

Mediastinal fat necrosis is a benign process that can occur after cardiac surgery or thoracic trauma, particularly in the setting of sternal wound infections. It can form a calcified fatty pseudotumor that should not be mistaken for a teratoma or liposarcoma.

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