Two unusual fat-containing mediastinal entities: Pearls and pitfalls in imaging of Morgagni hernia and fat necrosis

Epipericardial fat necrosis: a case report of an underdiagnosed disease

“…7 Chest X-ray findings are usually nonspecific and may include juxta-phrenic opacity and a small pleural effusion. 6 Chest CT is the standard for the diagnosis of EFN, 2 with typical findings that support the diagnosis. 6 The main feature is an ovoid-shaped softtissue mass of adipose tissue density and surrounding soft-tissue stranding, measuring approximately 30 3 20 mm.…”

“…6 In cases were Ga-97 scintigraphy is performed, a mildly increased gallium uptake has been reported, reflecting an inflammatory process. 6 In 2010, Fred et al reviewed 23 cases of EFN. 9 Regarding histologic findings, in the early course of the disease, a central focus of necrotic fat cells surrounded by macrophages with intense neutrophilic infiltration is seen.…”

“… 6 In cases were Ga-97 scintigraphy is performed, a mildly increased gallium uptake has been reported, reflecting an inflammatory process. 6 …”

“…5 Laboratory findings including troponin, D-dimer, and creatine kinase titers are commonly within the normal range. 6 Electrocardiography and echocardiography usually show no abnormal findings. Increased C-reactive protein has been reported with no other abnormal laboratory findings.…”

“…6 Chest CT is the standard for the diagnosis of EFN, 2 with typical findings that support the diagnosis. 6 The main feature is an ovoid-shaped softtissue mass of adipose tissue density and surrounding soft-tissue stranding, measuring approximately 30 3 20 mm. 3 Inflammatory changes of the adjacent pericardium may be seen, although Internal Medicine Department, Centro Hospitalar Universit ário São João, Porto.…”