CTICasesLarge Morgagni Hernia
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Imaging findings
Chest radiograph shows a large, well-demarcated mediastinal mass. CT reveals a large fatty mass with interspersed soft tissue and vessels extending from the abdomen into the anterior mediastinum, with absence of the right hemidiaphragm in this region. The "soft tissue" previously thought to be thymic tissue was actually vessels coursing upwards from the abdomen.
Key takeaways
Morgagni hernias are congenital diaphragmatic hernias, typically located anteriorly and paramedian. They can contain omental fat, liver, or bowel. Large hernias can present as mediastinal masses on chest radiographs. CT helps characterize the contents and confirm diaphragmatic defect, differentiating them from other anterior mediastinal masses like thymolipomas. The presence of abdominal vessels coursing into the mass is a key clue.
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