Presentation
Incidental finding in patient presenting with acute PE.
Patient Data
There is a right atrial intracardiac mass with the same density as subcutaneous fat layer, measuring 5.4 x 2.9 cm, suggesting a lipoma.
Evidence of hypoattenuating filling defect noted in the anterior segment of left lower pulmonary arteries, with contrast passage around it, suggesting acute PE.
Mild septal thickening and atelectasis bands noted bilaterally. Few bilateral small pneumatocoele are noted, the largest in the superior segment of right lower lobe measures about 7 x 7 mm. There is bleb noted in the right upper lobe measures about 1.9 x 0.7 cm.
The thoracic aorta is also unremarkable.
Case Discussion
Cardiac lipoma is an uncommon benign primary cardiac neoplasm although it is considered the commonest non-myxomatous benign primary cardiac tumor. It is mostly benign in origin. It is rarely presented in the right atrium. It is usually an incidental finding during the examination by echo or other imaging modalities.
CT scan is considered a sufficiently sensitive tool to diagnose intracardiac lipoma.
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