CTICasesParaspinal Lipoma
Imaging findings
A radiograph shows a smooth extra bump along the right paravertebral region, in a location where a paraspinal neurogenic tumor or vascular lesion is considered. CT shows a fat-attenuation mass with a thin capsule, consistent with a paraspinal lipoma, with a corresponding fatty finding on the lateral view.
Key takeaways
A smooth paravertebral opacity should prompt inspection of the paraspinal lines, and while a fat-containing hiatal hernia is the more common explanation, a true paraspinal lipoma (fat attenuation with a thin capsule) is a benign cause. A hiatal hernia would obscure the posterior heart border, so a crisp back wall of the heart on the lateral view helps exclude it.
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