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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Mediastinal fat necrosis (MFN)
Synonyms
- Epipericardial fat necrosis
- Pericardial fat necrosis
- Misnomer; there is no pericardial fat
- "Mediastinal fat necrosis"
- Preferred over "epipericardial fat necrosis"; lesions do occur away from pericardium
Definitions
- Rare self-limiting cause of pleuritic chest pain
- Necrosis of mediastinal fat
- Subepicardial fat: Immediately adjacent to myocardium
- Deep to serous visceral pericardium or epicardium
- Epiperi-cardial fat: Mediastinal fat superficial to pericardium
- Rare self-limiting cause of pleuritic chest pain
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
- Zafar MR et al: Epipericardial fat necrosis: a concise review of literature. Cureus. 13(2):e13106, 2021
- Cafezeiro CRF et al: Epipericardial fat necrosis as cause of chest pain in patient after heart transplantation. Am J Transplant. 20(5):1451-3, 2020
- Gayer G: Mediastinal (epipericardial) fat necrosis: an overlooked and little known cause of acute chest pain mimicking acute coronary syndrome. Semin Ultrasound CT MR. 38(6):629-33, 2017
- Gayer G: Thoracolithiasis-computed tomography findings of intrapleural loose bodies. Semin Ultrasound CT MR. 38(6):634-40, 2017
- Giassi KS et al: Epipericardial fat necrosis: who should be a candidate? AJR Am J Roentgenol. 207(4):773-7, 2016
- Giassi Kde S et al: Epipericardial fat necrosis: an underdiagnosed condition. Br J Radiol. 87(1038):20140118, 2014
- Bhatt MY et al: Imaging manifestations of mediastinal fat necrosis. Case Rep Radiol. 2013:323579, 2013
- Ataya D et al: Epipericardial fat pad necrosis: computed tomography findings and literature review. J Thorac Imaging. 26(4):W140-2, 2011
- Fred HL: Pericardial fat necrosis: a review and update. Tex Heart Inst J. 37(1):82-4, 2010
- Pineda V et al: Epipericardial fat necrosis: radiologic diagnosis and follow-up. AJR Am J Roentgenol. 185(5):1234-6, 2005
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Mediastinal fat necrosis (MFN)
Synonyms
- Epipericardial fat necrosis
- Pericardial fat necrosis
- Misnomer; there is no pericardial fat
- "Mediastinal fat necrosis"
- Preferred over "epipericardial fat necrosis"; lesions do occur away from pericardium
Definitions
- Rare self-limiting cause of pleuritic chest pain
- Necrosis of mediastinal fat
- Subepicardial fat: Immediately adjacent to myocardium
- Deep to serous visceral pericardium or epicardium
- Epiperi-cardial fat: Mediastinal fat superficial to pericardium
- Rare self-limiting cause of pleuritic chest pain
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
- Zafar MR et al: Epipericardial fat necrosis: a concise review of literature. Cureus. 13(2):e13106, 2021
- Cafezeiro CRF et al: Epipericardial fat necrosis as cause of chest pain in patient after heart transplantation. Am J Transplant. 20(5):1451-3, 2020
- Gayer G: Mediastinal (epipericardial) fat necrosis: an overlooked and little known cause of acute chest pain mimicking acute coronary syndrome. Semin Ultrasound CT MR. 38(6):629-33, 2017
- Gayer G: Thoracolithiasis-computed tomography findings of intrapleural loose bodies. Semin Ultrasound CT MR. 38(6):634-40, 2017
- Giassi KS et al: Epipericardial fat necrosis: who should be a candidate? AJR Am J Roentgenol. 207(4):773-7, 2016
- Giassi Kde S et al: Epipericardial fat necrosis: an underdiagnosed condition. Br J Radiol. 87(1038):20140118, 2014
- Bhatt MY et al: Imaging manifestations of mediastinal fat necrosis. Case Rep Radiol. 2013:323579, 2013
- Ataya D et al: Epipericardial fat pad necrosis: computed tomography findings and literature review. J Thorac Imaging. 26(4):W140-2, 2011
- Fred HL: Pericardial fat necrosis: a review and update. Tex Heart Inst J. 37(1):82-4, 2010
- Pineda V et al: Epipericardial fat necrosis: radiologic diagnosis and follow-up. AJR Am J Roentgenol. 185(5):1234-6, 2005
