J Korean Soc Radiol.  2015 Apr;72(4):250-254. 10.3348/jksr.2015.72.4.250.

Right Ventricular Lipomatous Mass and Biventricular Multifocal Fat in a Young Woman: A Case Report

• Lee B
• Park JH
• Ahn KT
• Kim SS
• Jeong JO
• Choi SW
• Jin SA
• Lee JH

• KMID: 1941755
• DOI: http://doi.org/10.3348/jksr.2015.72.4.250

Abstract

Cardiac lipoma is a rare neoplasm of encapsulated mature adult adipose tissue. It is usually asymptomatic, but it may be related to hemodynamic obstruction depending on its location. We report a typical case of right ventricular lipomatous mass and multifocal fat infiltration of both ventricles, which were detected incidentally in a young woman.

MeSH Terms

Adipose Tissue
Adult
Echocardiography
Female
Heart Ventricles
Hemodynamics
Humans
Lipoma

Figure

• 

  Fig. 1 A 31-year-old pregnant woman with spontaneous mass-like lesions in the RV. Transthoracic echocardiogram shows lobulated, hyperechoic mass (arrow) on the RV side of the interventricular septum (parasternal long axis view, A). Another linear mass lesion (arrows) is noted in the RV attached on the apical portion (modified low parasternal view, B), and round mass lesion (arrowhead) is also found on the free wall of the RV without hemodynamic obstruction on the color flow mapping (C, D). Axial pre-enhanced and contrast-enhanced cardiac computed tomography (CT) scans show a homogenous, well-defined, fatty attenuated mass (-70 Hounsfield units), broadly based on the endocardial surface of the interventricular septum of RV (E, G) and other smaller fatty attenuated amorphous lesions are present along the trabeculae and moderator band of RV as well as on the endocardial surface of the interventricular septum of the LV (arrows, F, H). On contrast-enhanced cardiac CT images (G, H), these lesions remained as a fatty attenuation without inner enhancing portion and these fatty attenuated lesions are demarcated well from the interventricular septum and RV free wall without showing myocardial invasion. Note.-RV = right ventricle, LV = left ventricle, RA = right atrium, LA = left atrium

Reference

1. Roberts WC. Primary and secondary neoplasms of the heart. Am J Cardiol. 1997; 80:671–682.

2. Rajiah P, To AC, Tan CD, Schoenhagen P. Multimodality imaging of an unusual case of right ventricular lipoma. Circulation. 2011; 124:1897–1898.

3. Araoz PA, Mulvagh SL, Tazelaar HD, Julsrud PR, Breen JF. CT and MR imaging of benign primary cardiac neoplasms with echocardiographic correlation. Radiographics. 2000; 20:1303–1319.

4. Sanal HT, Kocaogğlu M, Yildirim D, Ors F. Multiple cardiac lipomas and pericardial lipomatosis: multidedector-row computer tomography findings. Int J Cardiovasc Imaging. 2007; 23:655–658.

5. Marcus FI, McKenna WJ, Sherrill D, Basso C, Bauce B, Bluemke DA, et al. Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the task force criteria. Circulation. 2010; 121:1533–1541.

6. Tuna IC, Julsrud PR, Click RL, Tazelaar HD, Bresnahan DR, Danielson GK. Tissue characterization of an unusual right atrial mass by magnetic resonance imaging. Mayo Clin Proc. 1991; 66:498–501.

7. Carpenter HM. Myocardial fat infiltration. Am Heart J. 1962; 63:491–496.

8. Kim SS, Ko SM, Song MG. Linear fat deposition in the middle layer of the left ventricular myocardium: computed tomographic findings. Korean J Radiol. 2010; 11:571–573.

9. Araoz PA, Eklund HE, Welch TJ, Breen JF. CT and MR imaging of primary cardiac malignancies. Radiographics. 1999; 19:1421–1434.

10. Kimura F, Matsuo Y, Nakajima T, Nishikawa T, Kawamura S, Sannohe S, et al. Myocardial fat at cardiac imaging: how can we differentiate pathologic from physiologic fatty infiltration? Radiographics. 2010; 30:1587–1602.