CTICasesMediastinal Fat Necrosis
Imaging findings
Initial chest radiographs in a patient presenting with acute, localized anterior rib pain reveal a subtle, vague soft tissue opacity in the right anterior cardiophrenic angle. Follow-up chest CT demonstrates a localized area of fat attenuation with surrounding inflammatory stranding and adjacent reactive atelectasis in the low anterior mediastinum, closely mimicking a Morgagni hernia. A follow-up CT scan obtained six months later shows complete resolution of the inflammatory fat stranding and atelectasis, confirming the diagnosis.
Key takeaways
Mediastinal fat necrosis is a benign, self-limiting inflammatory process that occurs due to aseptic necrosis of mediastinal fat, typically presenting with acute, localized pleuritic or chest wall pain. On CT, it presents as an encapsulated fat-density lesion with surrounding inflammatory stranding, often located in the cardiophrenic angles where it can easily be mistaken for an incarcerated diaphragmatic hernia. Demonstrating complete resolution on follow-up imaging confirms the benign nature of this condition and avoids unnecessary surgical exploration.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Small Cell Lung CarcinomaNeoplastic
- Blunt Cardiac Injury with Myocardial Shear StrainTrauma
- Vaccine-Associated MyocarditisInflammatory
- Morgagni HerniaCongenital
- Desquamative Interstitial Pneumonia in SclerodermaILD
- Unilateral Pulmonary Vein AtresiaCongenital
- Coronary Artery Pseudoaneurysm Post-PCIIatrogenic
- Cystic Fibrosis with Severe Small Airways DiseaseCongenital
See all cases from June 12, 2021 →
Related Artifact cases
- Skin Fold Artifact Mimicking Pneumothorax
- Transplanted Donor Liver with Retained Bullet Fragment
- Migratory Calcified Pleural Bodies from Extrapleural Fat Necrosis
- Acutely Enlarging Thymic Cyst in a Transplant Patient
- Benign Colonic Pneumatosis after Lung Transplant
- Transdiaphragmatic Air via the Foramen of Morgagni (Macklin Phenomenon)