Cardiac lipoma

• Slow growing neoplasm of mature adipose tissue
• Arise from epicardium, myocardium or endocardium, even interatrial septum
• Common in right atrium at level of interatrial septum
• Epicardial location, narrow attachment point and growth into pericardial space is typical

Imaging

• CT
  • Well circumscribed
  • Homogeneous fat attenuation (-50 to -150 HU)
  • Occasionally show internal soft tissue septa
  • D/D: lipomatous hypertrophy of interatrial septum. Accumulation of brown fat results in diameter of septum > 2 cm. It spares the fossa ovalis giving a dumb-bell appearance
• MRI
  • Fat signal in T1 and T2
  • No soft tissue component
  • No contrast enhancement
  • If any soft tissue component or enhancement seen – possible sarcomatous change

Read more

Kimura, Fumiko, et al. “Myocardial fat at cardiac imaging: how can we differentiate pathologic from physiologic fatty infiltration?.” Radiographics 30.6 (2010): 1587-1602.

Motwani, Manish, et al. “MR imaging of cardiac tumors and masses: a review of methods and clinical applications.” Radiology 268.1 (2013): 26-43.

Sparrow, Patrick J., et al. “MR imaging of cardiac tumors.” Radiographics 25.5 (2005): 1255-1276.