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Progressively enlarging paracardial lipoma in a child

¹ Department of Paediatric Radiology, Institute of Radiodiagnostics, ² University of Children's Hospital and ³ Institute of Pathology, University of Wuerzburg, Josef-Schneider-Straße 2, 97080 Wuerzburg, Germany

View larger version (57K): [in a new window]   Figure 1. (a) Chest radiograph performed to rule out pulmonary infection shows incidentally a triangular shadow in the cardiophrenic angle on the right side [Date of examination 20.11.00]. (b) Follow-up chest radiograph performed 7 weeks later due to recurrent airway infection demonstrates an enlargement of the mass even allowing for a slightly different inspiration [Date of examination 12.1.01].

View larger version (37K): [in a new window]   Figure 2. (a) Ultrasound shows a solid mass in the transverse plane with 4.4 x 5.0 cm2 [Date of examination 20.12.00]. (b) Follow-up ultrasound 5 weeks later demonstrates an enlargement of the mass in the transverse plane (5.9 x 5.7 cm2) [Date of examination 29.1.01].

View larger version (54K): [in a new window]   Figure 3. (a) MRI of the chest, T1 weighted turbo spin echo (TSE) sequence, repetition time (TR) 600 ms, echo time (TE) 32 ms, in transverse plane shows a fatty mass in the right cardiophrenic angle consistent with a lipoma [Date of examination 21.12.00]. (b) The follow-up MRI of the chest was performed due to the rapid enlargement of the mass. T1 weighted TSE-sequence, TR 600 ms, TE 32 ms, in the same plane as in the first examination. A significant enlargement of the fatty mass was noted without signs of malignancy. At the same time the thickness of the subcutaneous tissue had increased [Date of examination 30.1.01].

View larger version (133K): [in a new window]   Figure 4. Representative histology of the paracardial lipoma located underneath the mediastinal pleura (arrow). Absence of lipoblasts and mitoses. (H&E; x 100).