대한흉부영상의학회 Korean Society of Thoracic Radiology

대한흉부영상의학회 Weekly Case 메뉴

Close

대한흉부영상의학회 Weekly Case 검색
대한흉부영상의학회 Weekly Case 검색
Advanced Search..

Close

Weekly Chest CasesCases by Disease Category

Case No : 1307 Date 2022-11-07

Add to Favorites

  • Courtesy of Bo Da Nam, Jung Hwa Hwang / Department of Radiology, Soonchunhyang University Hospital, Seoul, Korea
  • Age/Sex 66 / M
  • Chief ComplaintRight chest pain
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5
  • Figure 6

Diagnosis With Brief Discussion

Diagnosis
Fat necrosis
Radiologic Findings
Initial chest radiography shows no significant finding on PA view (figure 1A) and foal increased opacity is suspected at anterior costophrenic area on lateral view (figure 1B).
Contrast-enhanced chest CT images (figure 2) show approximately 2cm sized well-defined fat density nodular lesion in anterior costophrenic area (5th
Brief Review
The patients symptoms improved after using a non-steroidal anti-inflammatory drug for a week.

Epipericardial fat necrosis (EFN) is an uncommon benign condition and usually presents as an acute pleuritic chest pain in previously healthy patients, which can mimic acute myocardial infarction, pulmonary embolism, or acute pericarditis. EFN is characterized as a self-limited inflammatory process occurring inside the epipericardial fat, which is the tissue that connects the pericardial layer to the anterior thoracic wall. The etiology of EFN is still unknown, similar to other analogous conditions such as epiploic appendatitis and fat necrosis in the omentum and breast.
The chest radiograph is non-specific and might reveal an ill-defined opacity near the cardiophrenic angle on the side that pain is presenting, with or without pleural effusion.
Chest CT is the modality of choice for diagnosing EFN. EFN usually presents in CT as a round, encapsulated, fatty lesion with inflammatory changes such as dense strands, thickening of the adjacent pericardium or pleura. Pleural effusion can also be present at the time of diagnosis.
The treatment is conservative and non-steroidal anti-inflammatory drugs are usually sufficient to relieve the symptoms.
References
1. K. D Giassi, A. N. Costa, G.H. Bachion, A. Apanaviviou, J. R. P. Filho, D.A.Lynch. Br J Radiol. June 2014; 87(1038):20140118.
2. V. Pineda, J. Caceres, J. Andreu, J. Vilar, M. L. Domingo. AJR Am J Roentgenol 2005; 185(5):1234-1236.
Keywords

No. of Applicants : 99

▶ Correct Answer : 73/99,  73.7%
  • - Ishikawa Matto Central Hospital , Japan MANABU AKIMOTO
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - , Japan HIROAKI ARAKAWA
  • - Jichi Medical University Hospital , Japan JUN KANZAWA
  • - ZIGONG TCM HOSPITAL OF CHINA , China CAO CUN YOU
  • - , Japan KYOKO NAGAI
  • - Niigata University , Japan ATSUSHI UEHARA
  • - , Japan MASAKI UMEHANA
  • - Showa General Hospital , Japan MASAFUMI KAIUME
  • - Shiga University of Medical Science , Japan AKITOSHI INOUE
  • - Hospital of Sacred Heart, Montreal , Canada ANDREA OJANGUREN
  • - McGill University Health Center , Canada ALEXANDRE SEMIONOV
  • - Kyoto University Hospital , Japan YUSUKE UTSUNOMIYA
  • - National Center of Neurology and Psychiatry , Japan MOTO NAKAYA
  • - Seoul National University Hospital , Korea (South) HYUNGIN PARK
  • - , Italy PAOLO BALDASSARI
  • - Tiger Gate Hospital , Japan SHIN-ICHI CHO
  • - Chonnam National University Hwasun Hospital , Korea (South) HONG SEOK CHOI
  • - Other , Korea (South) HWANGHEE JO
  • - Asan Medical Center , Korea (South) EUNJI CHOI
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Scans world , India PHILSON JOSEPH MUKKADA
  • - Oita University, Faculty of Medicine , Japan FUMITO OKADA
  • - Seoul Medical Center , Korea (South) HYUK GI HONG
  • - Beaulieu clinic Geneva , Switzerland GILLES GENIN
  • - Osaka University , Japan AKINORI HATA
  • - Korea University Guro Hospital , Korea (South) HEEJUN PARK
  • - Osaka Metropolitan University , Japan HIROTAKA TAKITA
  • - Wonkwang University Hospital , Korea (South) HYOJOO KIM
  • - Shimada General Medical Center , Japan HAYATO NOZAWA
  • - , Korea (South) MINJI KIM
  • - Soonchunhyang University Hospital Bucheon , Korea (South) HYEJOO PARK
  • - Other , Korea (South) HYEON IL CHOI
  • - Ajou University Hospital , Korea (South) HYUNSEUNG LEE
  • - , Japan YUKIKO USUI
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Ajou University Hospital , Korea (South) JAYOUNG MOON
  • - Gifu University Hospital , Japan Yo Kaneko
  • - , Japan KENTARO KOTANI
  • - Kyoto University Hospital , Japan YASUHISA KURATA
  • - Ajou University Hospital , Korea (South) YOU NA KIM
  • - Other , Korea (South) CHAEHUN LIM
  • - , United States HIROAKI TAKAHASHI
  • - Osaka Metropolitan University Hospital , Japan SHU MATSUSHITA
  • - Chungbuk National University Hospital , Korea (South) MIHYEON PARK
  • - Jichi Medical University, School of Medicine , Japan MITSURU MATSUKI
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
  • - Eskisehir Sehir Hastanesi , Turkey MURAT SAHIN
  • - Osaka metropolitan university Hospital , Japan TATSUSHI OURA
  • - Dokkyo Medical University , Japan HIROAKI ARAKAWA
  • - Wuhan Union Hospital , China QIGUANG CHENG
  • - Chonnam National University Hwasun Hospital , Korea (South) JEONG YEOP LEE
  • - Other , Korea (South) KYU-CHONG LEE
  • - Mie University Hospital , Japan KENSUKE DOMAE
  • - Kyoto University Hospital , Japan SATOSHI IKEDA
  • - Nishida Hospital , Japan SHOJI OKUDA
  • - University of Tsukuba Hospital , Japan SODAI HOSHIAI
  • - , Japan SOTA MASUOKA
  • - Pusan National University Yangsan Hospital , Korea (South) JI HWAN KIM
  • - Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
  • - Toranomon Hospital , Japan KAORU SUMIDA
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Nerimahikarigaoka hospital , Japan TAKANA HAYASHI
  • - Matsunami General Hospital , Japan TARO TAKEDA
  • - , Japan YUMI MAEHARA
  • - , Japan YUKI HAYASHI
  • - Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
  • - The Catholic University of Korea Yoeuido St. Mary , Korea (South) CHAWOONG JEON
  • - , Korea (South) HM PARK
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - Hanyang University Hospital , Korea (South) SEUNG JIN YOO
  • - Jiangsu province hospital , China WANGJIAN ZHA
▶ Correct Answer as Differential Diagnosis : 6/99,  6.1%
  • - Other , Korea (South) SEONGSU KANG
  • - , Korea (South) JIN YOUNG LEE
  • - , Japan HIKARI FUKUI
  • - Other , Korea (South) SEONG WON JANG
  • - Paras hospital, Panchkula , India SHALEEN RANA
  • - Chonnam Hospital , Korea (South) JAEHYUN PARK
▶ Semi-Correct Answer : 1/99,  1.0%
  • - IRSA LA ROCHELLE , France JEAN LUC BIGOT
  • Top
  • Back

Each Case of This Site Supplied by the Members of KSTR.
Copyright of the Images is in the KSTR and Original Supplier.
Current Editor : Sang Young Oh, M.D., Ph.D Email : sangyoung.oh@gmail.com

This website is optimized for IE 10 and above.