Mediastinal Lipomatosis

An obese 56-year-old woman was hospitalized after 2 days of chest pain, shortness of breath, and palpitations. Physical examination revealed no abnormalities, and serial cardiac enzyme studies and an ECG ruled out myocardial infarction. However, transesophageal echocardiography showed a lesion in the mediastinum.

A CT scan of the chest revealed a mass in the mediastinum, and the diagnosis of mediastinal lipomatosis was confirmed by the tumor's characteristic low density (from 220 H to 2100 H). The patient's chest pain subsided without any intervention. Two years later, the mass showed no change in size, confirming a benign process.

Lipomatosis is often associated with obesity, corticosteroid treatment, or Cushing's disease. In most cases, the lesions are benign, although liposarcomas do arise in the mediastinum.