pleural lipoma

Based on the context provided, here is a description of pleural lipoma:

A pleural lipoma is a rare and benign tumor that develops from the adipose tissue in the pleura, which is the lining surrounding the lungs. It is typically slow-growing and has no potential for malignant transformation.

Characteristics of a pleural lipoma include:

• A well-defined, homogeneous mass with fat attenuation (HU less than –50) on CT scans
• Obtuse margins along the pleura, displacing adjacent structures
• Typically asymptomatic, but can cause compressive symptoms such as nonproductive cough, chest pain, and dyspnea if they reach a large size

Pleural lipomas are usually located in the mediastinum, bronchial, or pulmonary regions. They are often diagnosed coincidentally during imaging studies for unrelated reasons.

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Common Signs and Symptoms of Pleural Lipoma

Pleural lipomas are typically asymptomatic, but in some cases, they can cause compressive symptoms that may mimic other conditions. The following signs and symptoms have been reported:

• Nonproductive cough: A persistent cough without any mucus production (1)
• Chest pain: Pain or discomfort in the chest area (2)
• Dyspnea: Difficulty breathing or feeling short of breath (2, 5, 6, 12)
• Chest heaviness: A sensation of weight or pressure on the chest (7, 12)
• Back pain: Pain or discomfort in the back area (12)
• Exertional dyspnea: Shortness of breath during physical activity (12)

These symptoms may occur when the pleural lipoma reaches a sufficient size to compress surrounding structures. In most cases, however, pleural lipomas remain asymptomatic until incidental detection on imaging studies.

References:

[1] Mortman K.D., Ahari J. Pleural lipoma clinically mimicking the presentation of superior sulcus tumour upon initial evaluation. BMJ Case Rep. 2017;2017 doi: 10.1136/bcr-2017-222157

[2] Nov 5, 2024 — In some cases, it causes pleural irritation with an urge to cough. When large, it can cause chest heaviness, dyspnea and breathlessness

[3] by C Jayle · 2012 · Cited by 37 — In conclusion, pleural lipomas may cause complications such as haemorrhage and adjoining organ compression.

[4] Sometimes they may grow to a large size and cause compression symptoms such as dyspnea and dysphagia. Importantly, they have also been associated with ...

[5] by PP Arcuri · 2024 — Pleural lipomas are more frequent in the adult, typically asymptomatic, but sometimes they can appear with compressive symptoms such as dyspnea, chest pain and ...

[6] by M Chen · 2013 · Cited by 30 — Symptoms such as dyspnoea and dysphagia are show due to local compression on adjacent structures, such as the trachea or oesophagus. Our ...

[7] by C Jayle · 2012 · Cited by 37 — In conclusion, pleural lipomas may cause complications such as haemorrhage and adjoining organ compression.

[12] Symptoms may include nonproductive cough, back pain, exertional dyspnea, or a sensation of heaviness in the chest.

Pleural lipomas are rare benign tumors that can be challenging to diagnose, but various diagnostic tests can help confirm their presence.

• Chest X-ray: A chest X-ray is often the first imaging test performed to evaluate a pleural mass. It may show a well-defined, fat-attenuating mass in the pleura [8].
• Computed Tomography (CT) scan: CT scans are more sensitive than chest X-rays and can provide detailed images of the tumor. They can help confirm the diagnosis by showing a homogenous mass with fat density (-50 to -150 HU) [13].
• Magnetic Resonance Imaging (MRI): MRI is useful in evaluating the extent of the tumor and its relationship with surrounding structures. It can also provide information on the tumor's functional characteristics, such as diffusion-weighted imaging (DWI) [1].
• Ultrasound: Ultrasound examination may be used to evaluate the pleural mass and assess its size and location.
• Laboratory tests: Laboratory workup is usually normal in patients with pleural lipoma. However, it can help rule out other conditions that may cause similar symptoms.

It's worth noting that a specific preoperative diagnosis of pleural lipoma has not been possible, and the only reliable diagnostic method has been surgical exeresis [2].

Pleural Lipoma Differential Diagnosis

Pleural lipomas are rare benign tumors that can be challenging to diagnose due to their similarity in appearance to malignant lesions. The differential diagnosis for pleural lipoma includes:

• Liposarcoma: A type of cancerous tumor that can also appear as a fat-attenuating mass on imaging studies [1][2]. Liposarcomas are more aggressive and require more radical treatment than pleural lipomas.
• Fibromas: Benign tumors composed of fibrous tissue that can also present as a well-defined mass on imaging [3].
• Solitary Fibrous Tumor of the Pleura (SFTP): A rare type of tumor that can appear as a pleural mass, but is more likely to be malignant than a lipoma [4].

Key Features for Differential Diagnosis

To differentiate pleural lipoma from these conditions, it's essential to consider the following features:

• Imaging characteristics: Pleural lipomas typically show fat density on CT scans and no contrast enhancement, whereas liposarcomas may exhibit enhancing septa within the mass [5].
• Location: Pleural lipomas are more commonly found in the mediastinal, bronchial, or pulmonary levels, while pleural involvement is extremely rare [6].
• Growth pattern: Lipomas are usually asymptomatic and incidentally discovered, whereas malignant tumors tend to grow rapidly and cause compressive symptoms [7].

Importance of Accurate Diagnosis

Accurate diagnosis of pleural lipoma is crucial to avoid unnecessary invasive procedures and radical treatment. Dedicated imaging studies, such as CT or MRI, can help differentiate pleural lipomas from more aggressive conditions.

References:

[1] C Jayle · 2012 · Cited by 37 [2] CP Worden · 2020 · Cited by 6 [3] B Malik · 2021 · Cited by 3 [4] PP Arcuri · 2024 [5] C Jayle · 2012 · Cited by 37 [6] PP Arcuri · 2024 [7] CP Worden · 2020 · Cited by 6