CTICasesPosterior Mediastinal Lipoma
Imaging findings
CT shows a contour abnormality that, unlike the far more common hiatal hernia, contains uniform fat with a thin capsule and no gas, consistent with a posterior mediastinal lipoma rather than herniated abdominal fat.
Key takeaways
A capsulated fatty posterior mediastinal mass is a posterior mediastinal lipoma, an uncommon entity that must be distinguished from the far more frequent herniation of abdominal fat through the esophageal hiatus. The presence of a discrete capsule and the absence of gas favor a true lipoma over a hiatal hernia.
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