Intrathoracic Lipoma Research Articles

Intrathoracic Lipomas Demonstrated By Computed Tomography

Nine cases of intrathoracic lipoma are reported. Computed tomography (CT) proved to be helpful in the diagnosis and management of these cases. The attenuations of the masses ranged from -70 to -140 Hounsfield units (HU). In 4 cases, needle biopsies were taken, confirming lipoma with mature fat cells. One patient also had a coelomic cyst with an attenuation of 20 HU, which was confirmed at thoracotomy. Another had an atypical lipoma which infiltrated the thoracic wall but was benign. In conclusion, we recommended investigation with CT scan for the diagnosis of lipoma.

Computed tomography of a symptomatic infarcted thoracic lipoma

Intrathoracic lipomas are often asymptomatic and incidentally discovered on routine chest radiographs. An infarcted, pedunculated thoracic lipoma causing chest pain is described. The possibility of liposarcoma was suggested by an inhomogeneous computed tomography appearance and an attenuation value that was greater than that of normal subcutaneous fat.

A CASE OF MEDIASTINAL LIPOMA IN AN ADULT

A patient was a 43-year-old man with an anterior mediastinal lipoma, followed as an abnormal shadow of chest plain roentogenography for 21 years. CT revealed a mixed and low-density mass in the right anterior mediastinum. The CT number of the tumor was -100 units. The tumor was removed by thoracotomy. We discuss the clinical features of mediastinal lipomas in 16 adult cases reported in Japan. Many cases were found in the 40 to 59-year-old group, and no significant difference in the male-to-female ratio. Twelve of 16 cases were in the anterior mediastinum. Fifteen were intrathoracic lipomas. Five cases had subjective symptoms. Recently, CT has been found useful for the preoperative diagnosis of mediastinal lipoma. Surgical treatment is recommended.

Intrathoracic Lipomas in Children

An asymptomatic 8-year-old boy had had a large intrathoracic tumor for five years. When noninvasive technics proved fruitless in establishing a diagnosis, surgical removal was elected. A large posterior mediastinal lipoma was discovered. This is the 15th intrathoracic lipoma reported in the pediatric age group.

Intrathoracic lipomas: Report of three cases and review of the literature with emphasis on endobronchial lipoma

Intrathoracic lipomas are rare, benign neoplasms of unknown origin, with symptoms depending primarily on their location and size. They frequently represent on incidental roentgenographic finding and are clinically significant in that they may simulate malignant tumors and, when located endobronchially, may cause irreparable lung damage. Three cases of intrathoracic neoplasms are reported herein, and the English literature on the subject reviewed. In some cases, bronchoscopic examination may yield the diagnosis of endobronchial lipoma but, in general, thoracotomy is required for diagnosis. A more complete classification is suggested and the preferred mode of treatment is discussed.

Intrathoracic lipomas. A report of three cases and a review of the literature.

Intrathoracic lipomas are rarely seen, a total of 77 cases having been previously reported in the literature. An additional 3 cases were seen at Roswell Park Memorial Institute, and these are presented below. The diagnosis and management of these lesions will be discussed. Report of Cases Case 1. —A 53-year-old white man presented himself at Roswell Park in July, 1955. He had a 7-year history of dull ache in the anterior chest at the level of the left nipple. He had also developed a nonproductive cough one month prior to admission. A chest x-ray in July, 1952, showed a small density in the left lower lung field. A follow-up x-ray taken in November, 1952, showed no interval change in this density. On July 8, 1955, another chest x-ray taken at Roswell Park Memorial Institute showed a spherical mass immediately lateral to the apex of the heart. This was interpreted as

Subpleural lipoma.

Lipomas, which are relatively common in the subcutaneous tissues, occur only rarely in the thoracic cavity. In this position, they are usually related to the mediastinum (6, 7, 8, 12). Even rarer is the occurrence of subpleural or parietal tumors unconnected with the mediastinum. Three such cases were treated in The New York Hospital during the past five years. Case Reports Case I (Fig. 1): A 14-year-old white boy was admitted to the hospital because of an abnormal routine chest film, which had been taken two weeks previously. It demonstrated a 4 × 7 × 8-cm. density in the right posterior chest wall, opposite the sixth rib interspace. There was localized widening of the rib interspace with attenuation of the adjacent sixth and seventh ribs. On physical examination, a firm, nontender, 4 × 4-cm. mass was found to the right of the spine at the midscapular level, corresponding in position to the density on the chest film. At operation a large, yellow, fatty, dumbbell-shaped mass was found, extending from outside the chest wall through the sixth interspace into the posterior thoracic cavity. The entire mass was excised, and the pathological report was lipoma. Case II (Fig. 2): A 72-year-old white woman was admitted to the hospital without complaints. Two weeks prior to admission she fell, and roentgenograms were taken of the right shoulder for possible fracture. There was no evidence of bone injury, but a density was fortuitously discovered in the right chest. It measured 2 × 3.5 cm. and was adjacent to the lateral chest wall. Exploratory thoracotomy was undertaken and revealed a yellow, encapsulated, subpleural mass. Its base was in the intercostal space but did not penetrate it. The mass was resected and the pathological report was lipoma. Case III (Fig. 3): A 69-year-old white woman was admitted to the hospital for a retinal detachment. A routine chest film revealed a 3.5 × 4-cm., sharply circumscribed density in the left upper lung field adjacent to the lateral chest wall. A left thoracotomy was performed and a soft subpleural mass was found bulging into the pleural cavity. The mass, which did not penetrate the rib interspace, was completely removed. The pathological report was lipoma. Discussion Heuer (6, 7) divided intrathoracic lipomas into three groups: (a) hourglass tumors consisting of an intrathoracic and extrathoracic mass connected by a thin isthmus perforating the thoracic wall between the ribs; (b) anterior superior mediastinal masses which extend up into the root of the neck, presenting as visible and palpable tumors; (c) wholly intrathoracic masses, which are most commonly related to the mediastinum. Those masses separated from the mediastinum have been designated as subpleural lipomas and may be located beneath the costal or diaphragmatic pleura (2, 13). They are rare in the latter location.

MEDIASTINAL LIPOMA SIMULATING CARDIAC ENLARGEMENT

This case of a mediastinal lipoma is reported because, by its location and shape, it so closely simulated cardiac enlargement. Mediastinal tumor is not usually considered in the differential diagnosis of enlargement of the cardiac silhouette. Lipomas are uncommon intrathoracic neoplasms. Thirty-five of the 56 intrathoracic lipomas reported to date were in the mediastinum,1and only two of these lipomas were confused with cardiac enlargement. One was in Yater and Lyddane's series,1fand the other was presented by Sosman and Levine at a clinic during the annual meeting of the American College of Physicians in Boston in 1949. REPORT OF A CASE A 30-year-old white man who was an automobile salesman was admitted to the hospital on Jan. 10, 1952. On admission, the diagnosis cardiac enlargement with cause undetermined was made. The patient had been recalled to active duty as a Navy fighter pilot. During the routine physical

MEDIASTINAL LIPOMA: THE SUCCESSFUL REMOVAL OF 1,700 GRAM MASS: Case Report and Review of Recent Literature of Intrathoracic Lipomas

MEDIASTINAL LIPOMA: THE SUCCESSFUL REMOVAL OF 1,700 GRAM MASS: Case Report and Review of Recent Literature of Intrathoracic Lipomas

Intrathoracic mediastinal lipoma

The case history reported is that of a white male, aged forty-six, from whom a completely intrathoracic mediastinal lipoma was removed. The difficulties attendant upon diagnosis of such a lesion are briefly reviewed and suggestions to aid in future recognition emphasized. Roentgenographic and electrocardiographic investigations of this individual are presented. In addition, some of the postoperative complications are reported. The soldier made an excellent recovery and is one of the few patients recorded in the literature who had a completely intrathoracic lipoma extirpated and survived this operative procedure.

INTRATHORACIC LIPOMA; A CASE REPORT

Case Reports1 July 1942INTRATHORACIC LIPOMA; A CASE REPORTOSCAR SWINEFORD JR., M.D., F.A.C.P., CHARLES J. HARKRADER JR., M.D.OSCAR SWINEFORD JR., M.D., F.A.C.P.Search for more papers by this author, CHARLES J. HARKRADER JR., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-17-1-125 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe subject of intrathoracic neoplasms has been reviewed recently by Heuer and his associates.1, 3 They summarized all case reports to date. McCorkle, Koerth, and Donaldson2 tabulated the most common symptoms and signs of the cases of thoracic lipomata of each type reported before 1938.The following case of intrathoracic lipoma is reported because it is the second in which asthma was the chief complaint,2 and because it is the eighth largest of the 25 wholly intrathoracic lipomata now on record.CASE REPORTA 62 year old white single male was admitted in severe status asthmaticus and congestive failure of...Bibliography1. HEUERANDRUS GJWD: The surgery of mediastinal tumors, Am. Jr. Surg., 1940, l, 146-224. Google Scholar2. MCCORKLEKOERTHDONALDSON RGCJJM: Thoracic lipomas, Jr. Thoracic Surg., 1940, ix, 568-582. CrossrefGoogle Scholar3. HEUER GJ: The thoracic lipomas, Ann. Surg., 1933, xcviii, 801-819. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University, Virginia*Received for publication December 2, 1940.From the Allergy Clinic, Department of Internal Medicine, and the Department of Pathology, University of Virginia Medical School, Charlottesville, Virginia. 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