Imaging features of cardiac lipoma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

FAN Shuya ,  GUO Hongwei

Department of Cardiovascular Surgery, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100037, P.R.China;

Corresponding author：

GUO Hongwei, Email: ghwdr@sina.com

Keywords：

Cardiac lipoma; cardiac echocardiography; computed tomography; cardiac magnetic resonance imaging

DOI：

10.7507/1007-4848.201811056

Video：

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Cardiac lipoma is rare and benign entities of heart, and often discovered after autopsy incidentally because most patients remain completely asymptomatic. The symptoms of cardiac lipoma depend on their location and size within the heart, such as dyspnea, chest pain, arrhythmia, and even sudden death. Surgical interventions usually have good results. Up till now, there has been no any relevant large-scale randomized controlled trial, and even no precise guideline for treatment. Surgical procedures often depend on patients' clinical manifestations and changes of hemodynamics in cardiac vessels in order to relief the symptoms as well as abort the progress of the disease. Therefore, early diagnosis and close follow-up are necessary for timely treatment. This article aims to summarize the imageological examinations for cardiac lipoma, including echocardiography, computed tomography, magnetic resonance imaging along with their characteristics and advantages, in order to get better clinical strategies.

Citation： FAN Shuya, GUO Hongwei. Imaging features of cardiac lipoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(6): 606-610. doi: 10.7507/1007-4848.201811056 Copy

1.	Wu S, Teng P, Zhou Y, et al. A rare case report of giant epicardial lipoma compressing the right atrium with septal enhancement. J Cardiothorac Surg, 2015, 10: 150.
2.	Li D, Wang W, Zhu Z, et al. Cardiac lipoma in the interventricular septum: a case report. J Cardiothorac Surg, 2015, 10: 69.
3.	Kong F, Zhang W, Guo Q. Multiple well-differentiated cardiac liposarcoma with a concomitant myocardial lipoma: A case report. Mol Clin Oncol, 2018, 9(6): 617-621.
4.	Chen C, Chen M, Liu W, et al. Successful removal of giant mediastinal lipoma and liposarcoma involving both chest cavities: Two case reports. Medicine (Baltimore), 2018, 97(32): e11806.
5.	Rocha RV, Butany J, Cusimano RJ. Adipose tumors of the heart. J Card Surg, 2018, 33(8): 432-437.
6.	Cannavale G, Francone M, Galea N, et al. Fatty images of the heart: spectrum of normal and pathological findings by computed tomography and cardiac magnetic resonance imaging. Biomed Res Int, 2018, 2018: 5610347.
7.	Steger CM. Primary liposarcoma of the heart. BMJ Case Rep, 2011, 2011. pii: bcr0320114013.
8.	Papavdi A, Agapitos E. Undiagnosed primary cardiac liposarcoma in an adult: a case report and review of the literature. Am J Forensic Med Pathol, 2013, 34(4): 299-301.
9.	D'Souza J, Shah R, Abbass A, et al. Invasive cardiac lipoma: a case report and review of literature. BMC Cardiovasc Disord, 2017, 17(1): 28.
10.	Vanoverbeke H. Resection of giant mediastinal liposarcoma. Acta Cardiol, 2014, 69(3): 311-312.
11.	Jing W, Lan T, Chen H, et al. Amplification of FRS2 in atypical lipomatous tumour/well-differentiated liposarcoma and de-differentiated liposarcoma: a clinicopathological and genetic study of 146 cases. Histopathology, 2018, 72(7): 1145-1155.
12.	Xia H, Gan L, Jiang Y, et al. Use of transesophageal echocardiography and contrast echocardiography in the evaluation of cardiac masses. Int J Cardiol, 2017, 236: 466-472.
13.	Beck MA, Cianciulli TF, Saccheri MC, et al. Intrapericardial lipoma mimicking atrial tumour. Eur Heart J Cardiovasc Imaging, 2017, 18(6): 721.
14.	Fang L, He L, Chen Y, et al. Infiltrating lipoma of the right ventricle involving the interventricular septum and tricuspid valve: report of a rare case and literature review. Medicine (Baltimore), 2016, 95(3): e2561.
15.	Hoey ET, Mankad K, Puppala S, et al. MRI and CT appearances of cardiac tumours in adults. Clin Radiol, 2009, 64(12): 1214-1230.
16.	杨静茹, 高金花. 原发性心脏脂肪瘤的病理学及超声心动图学特征研究. 河北医学, 2010, 16(6): 672-674.
17.	Buckley O, Madan R, Kwong R, et al. Cardiac masses, part 1: imaging strategies and technical considerations. AJR Am J Roentgenol, 2011, 197(5): W837-W841.
18.	Mueller J, Jeudy J, Poston R, et al. Cardiac CT angiography after coronary bypass surgery: prevalence of incidental findings. AJR Am J Roentgenol, 2007, 189(2): 414-419.
19.	Kassop D, Donovan MS, Cheezum MK, et al. Cardiac masses on cardiac CT: a review. Curr Cardiovasc Imaging Rep, 2014, 7: 9281.
20.	蔡建辉, 谷文涛, 张京, 等. CT 成像及 MPR 在诊断心脏脂肪瘤中的应用价值. 实用医学影像杂志, 2011, 12(3): 163-164, 173.
21.	Cody DD, Mahesh M. AAPM/RSNA physics tutorial for residents: Technologic advances in multidetector CT with a focus on cardiac imaging. Radiographics, 2007, 27(6): 1829-1837.
22.	Salanitri JC, Pereles FS. Cardiac lipoma and lipomatous hypertrophy of the interatrial septum: cardiac magnetic resonance imaging findings. J Comput Assist Tomogr, 2004, 28(6): 852-856.
23.	Barbuto L, Ponsiglione A, Del Vecchio W, et al. Humongous right atrial lipoma: a correlative CT and MR case report. Quant Imaging Med Surg, 2015, 5(5): 774-777.
24.	吴成强, 桂春. MSCT 诊断心脏占位性病变的研究进展. 山东医药, 2018, 58(1): 92-95.
25.	O'Donnell DH, Abbara S, Chaithiraphan V, et al. Cardiac tumors: optimal cardiac MR sequences and spectrum of imaging appearances. AJR Am J Roentgenol, 2009, 193(2): 377-387.
26.	Braggion-Santos MF, Koenigkam-Santos M, Teixeira SR, et al. Magnetic resonance imaging evaluation of cardiac masses. Arq Bras Cardiol, 2013, 101(3): 263-272.
27.	Açar B, Ünal S, Aladağ P, et al. Interventricular septal lipoma. Turk Kardiyol Dern Ars, 2017, 45(8): 770.
28.	Díaz Angulo C, Méndez Díaz C, Rodríguez García E, et al. Imaging findings in cardiac masses (Part Ⅰ): study protocol and benign tumors. Radiologia, 2015, 57(6): 480-488.
29.	Puvaneswary M, Edwards JR, Bastian BC, et al. Pericardial lipoma: ultrasound, computed tomography and magnetic resonance imaging findings. Australas Radiol, 2000, 44(3): 321-324.
30.	Nadra I, Dawson D, Schmitz SA, et al. Lipomatous hypertrophy of the interatrial septum: a commonly misdiagnosed mass often leading to unnecessary cardiac surgery. Heart, 2004, 90(12): e66.
31.	Fussen S, De Boeck BW, Zellweger MJ, et al. Cardiovascular magnetic resonance imaging for diagnosis and clinical management of suspected cardiac masses and tumours. Eur Heart J, 2011, 32(12): 1551-1560.
32.	Motwani M, Kidambi A, Herzog BA, et al. MR imaging of cardiac tumors and masses: a review of methods and clinical applications. Radiology, 2013, 268(1): 26-43.
33.	Naseerullah FS, Javaiya H, Murthy A. Cardiac lipoma: an uncharacteristically large intra-atrial mass causing symptoms. Case Rep Cardiol, 2018, 2018: 3531982.
34.	Gulati G, Sharma S, Kothari SS, et al. Comparison of echo and MRI in the imaging evaluation of intracardiac masses. Cardiovasc Intervent Radiol, 2004, 27(5): 459-469.
35.	Slonimsky E, Konen O, Di Segni E, et al. Cardiac MRI: a useful tool for differentiating cardiac thrombi from tumors. Isr Med Assoc J, 2018, 20(8): 472-475.
36.	Kleiman AM, Harding LM, Bechtel AJ. Concomitant lipomatous hypertrophy and left atrial mass: Distinguishing benign from malignant. Echocardiography, 2018, 35(4): 534-536.

1. Wu S, Teng P, Zhou Y, et al. A rare case report of giant epicardial lipoma compressing the right atrium with septal enhancement. J Cardiothorac Surg, 2015, 10: 150.
2. Li D, Wang W, Zhu Z, et al. Cardiac lipoma in the interventricular septum: a case report. J Cardiothorac Surg, 2015, 10: 69.
3. Kong F, Zhang W, Guo Q. Multiple well-differentiated cardiac liposarcoma with a concomitant myocardial lipoma: A case report. Mol Clin Oncol, 2018, 9(6): 617-621.
4. Chen C, Chen M, Liu W, et al. Successful removal of giant mediastinal lipoma and liposarcoma involving both chest cavities: Two case reports. Medicine (Baltimore), 2018, 97(32): e11806.
5. Rocha RV, Butany J, Cusimano RJ. Adipose tumors of the heart. J Card Surg, 2018, 33(8): 432-437.
6. Cannavale G, Francone M, Galea N, et al. Fatty images of the heart: spectrum of normal and pathological findings by computed tomography and cardiac magnetic resonance imaging. Biomed Res Int, 2018, 2018: 5610347.
7. Steger CM. Primary liposarcoma of the heart. BMJ Case Rep, 2011, 2011. pii: bcr0320114013.
8. Papavdi A, Agapitos E. Undiagnosed primary cardiac liposarcoma in an adult: a case report and review of the literature. Am J Forensic Med Pathol, 2013, 34(4): 299-301.
9. D'Souza J, Shah R, Abbass A, et al. Invasive cardiac lipoma: a case report and review of literature. BMC Cardiovasc Disord, 2017, 17(1): 28.
10. Vanoverbeke H. Resection of giant mediastinal liposarcoma. Acta Cardiol, 2014, 69(3): 311-312.
11. Jing W, Lan T, Chen H, et al. Amplification of FRS2 in atypical lipomatous tumour/well-differentiated liposarcoma and de-differentiated liposarcoma: a clinicopathological and genetic study of 146 cases. Histopathology, 2018, 72(7): 1145-1155.
12. Xia H, Gan L, Jiang Y, et al. Use of transesophageal echocardiography and contrast echocardiography in the evaluation of cardiac masses. Int J Cardiol, 2017, 236: 466-472.
13. Beck MA, Cianciulli TF, Saccheri MC, et al. Intrapericardial lipoma mimicking atrial tumour. Eur Heart J Cardiovasc Imaging, 2017, 18(6): 721.
14. Fang L, He L, Chen Y, et al. Infiltrating lipoma of the right ventricle involving the interventricular septum and tricuspid valve: report of a rare case and literature review. Medicine (Baltimore), 2016, 95(3): e2561.
15. Hoey ET, Mankad K, Puppala S, et al. MRI and CT appearances of cardiac tumours in adults. Clin Radiol, 2009, 64(12): 1214-1230.
16. 杨静茹, 高金花. 原发性心脏脂肪瘤的病理学及超声心动图学特征研究. 河北医学, 2010, 16(6): 672-674.
17. Buckley O, Madan R, Kwong R, et al. Cardiac masses, part 1: imaging strategies and technical considerations. AJR Am J Roentgenol, 2011, 197(5): W837-W841.
18. Mueller J, Jeudy J, Poston R, et al. Cardiac CT angiography after coronary bypass surgery: prevalence of incidental findings. AJR Am J Roentgenol, 2007, 189(2): 414-419.
19. Kassop D, Donovan MS, Cheezum MK, et al. Cardiac masses on cardiac CT: a review. Curr Cardiovasc Imaging Rep, 2014, 7: 9281.
20. 蔡建辉, 谷文涛, 张京, 等. CT 成像及 MPR 在诊断心脏脂肪瘤中的应用价值. 实用医学影像杂志, 2011, 12(3): 163-164, 173.
21. Cody DD, Mahesh M. AAPM/RSNA physics tutorial for residents: Technologic advances in multidetector CT with a focus on cardiac imaging. Radiographics, 2007, 27(6): 1829-1837.
22. Salanitri JC, Pereles FS. Cardiac lipoma and lipomatous hypertrophy of the interatrial septum: cardiac magnetic resonance imaging findings. J Comput Assist Tomogr, 2004, 28(6): 852-856.
23. Barbuto L, Ponsiglione A, Del Vecchio W, et al. Humongous right atrial lipoma: a correlative CT and MR case report. Quant Imaging Med Surg, 2015, 5(5): 774-777.
24. 吴成强, 桂春. MSCT 诊断心脏占位性病变的研究进展. 山东医药, 2018, 58(1): 92-95.
25. O'Donnell DH, Abbara S, Chaithiraphan V, et al. Cardiac tumors: optimal cardiac MR sequences and spectrum of imaging appearances. AJR Am J Roentgenol, 2009, 193(2): 377-387.
26. Braggion-Santos MF, Koenigkam-Santos M, Teixeira SR, et al. Magnetic resonance imaging evaluation of cardiac masses. Arq Bras Cardiol, 2013, 101(3): 263-272.
27. Açar B, Ünal S, Aladağ P, et al. Interventricular septal lipoma. Turk Kardiyol Dern Ars, 2017, 45(8): 770.
28. Díaz Angulo C, Méndez Díaz C, Rodríguez García E, et al. Imaging findings in cardiac masses (Part Ⅰ): study protocol and benign tumors. Radiologia, 2015, 57(6): 480-488.
29. Puvaneswary M, Edwards JR, Bastian BC, et al. Pericardial lipoma: ultrasound, computed tomography and magnetic resonance imaging findings. Australas Radiol, 2000, 44(3): 321-324.
30. Nadra I, Dawson D, Schmitz SA, et al. Lipomatous hypertrophy of the interatrial septum: a commonly misdiagnosed mass often leading to unnecessary cardiac surgery. Heart, 2004, 90(12): e66.
31. Fussen S, De Boeck BW, Zellweger MJ, et al. Cardiovascular magnetic resonance imaging for diagnosis and clinical management of suspected cardiac masses and tumours. Eur Heart J, 2011, 32(12): 1551-1560.
32. Motwani M, Kidambi A, Herzog BA, et al. MR imaging of cardiac tumors and masses: a review of methods and clinical applications. Radiology, 2013, 268(1): 26-43.
33. Naseerullah FS, Javaiya H, Murthy A. Cardiac lipoma: an uncharacteristically large intra-atrial mass causing symptoms. Case Rep Cardiol, 2018, 2018: 3531982.
34. Gulati G, Sharma S, Kothari SS, et al. Comparison of echo and MRI in the imaging evaluation of intracardiac masses. Cardiovasc Intervent Radiol, 2004, 27(5): 459-469.
35. Slonimsky E, Konen O, Di Segni E, et al. Cardiac MRI: a useful tool for differentiating cardiac thrombi from tumors. Isr Med Assoc J, 2018, 20(8): 472-475.
36. Kleiman AM, Harding LM, Bechtel AJ. Concomitant lipomatous hypertrophy and left atrial mass: Distinguishing benign from malignant. Echocardiography, 2018, 35(4): 534-536.

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Imaging features of cardiac lipoma

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