Clinical History
A 74-year-old male patient presented with dyspnea and bloody sputum.
Imaging Findings
The 74-year-old male patient who was a cigarette smoker, presented with a history of dyspnea and a recent appearance of bloody sputum. Radiography of the chest was performed, which showed a mass in
the left upper lobe. The findings on a CT scan indicated a probable carcinoma of the lung and the presence of a posteromedial intracaval fat-mass-like lesion at the level of confluence of the hepatic
veins and the inferior vena cava.
Discussion
A juxtacaval fat pad is a normal focal collection of fat, adjacent to or projecting into the inferior vena cava (IVC). It mimics an intraluminal mass of fat attenuation in the subdiaphragmatic IVC,
which can be mistaken for a thrombus. On axial CT scans, the fat collection is seen to have a round or oval shape, and is located posteromedially to the IVC. Coronal reformatted images show the
extraluminal location of the mass. It is a normal variant of the distribution of the fat around the subdiaphragmatic esophagus. This finding occurs in 0.5% of adults undergoing an abdominal CT scan.
We conclude that juxtacaval fat pad has no clinical significance and we should not misinterpret it as an abnormality.
Differential Diagnosis List