CTICasesExtrapleural Chest Wall Lipoma
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Imaging findings
Chest radiograph demonstrates a large, abnormal opacity in the chest, representing a dramatic and unexpected incidental finding. CT imaging reveals that this is a large, mostly fatty mass located outside the parietal pleura, confirming its extrapleural chest wall location. While the mass contains some higher-density linear structures representing internal blood vessels, it consists entirely of well-behaved, ordinary fat without more complex tissue elements.
Key takeaways
Ordinary lipomas can present as very large, extrapleural chest wall lesions that may grow underneath the parietal pleura or show intramuscular or exophytic extension into the chest wall. When evaluating these masses on CT, the presence of internal vascular structures or thin septations can sometimes raise concern for a well-differentiated liposarcoma. However, if no soft tissue nodularity, thick septa, or other suspicious solid elements are present, a benign lipoma remains the primary diagnosis, which can be confirmed upon surgical resection.
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