Pseudolipoma of the Glisson capsule

Pseudolipoma of the Glisson capsule is an uncommon developmental anomaly in which a piece of colonic epiploic fat becomes ectopically located within the liver capsule.

Radiographic features

CT

• well-circumscribed fat attenuation (-20 to -70 HU) nodule at the liver surface
• it can sometimes have soft tissue attenuation and can have a small peripheral calcification

MRI

• well-circumscribed nodule at the liver surface that follows fat signal intensity on all sequences and suppresses with fat saturation

Differential diagnosis

They might be mistaken by peripheral intra-hepatic fat-containing lesions and, therefore, the differential diagnosis would include:

• hepatic lipoma
• hepatic adenoma
• focal hepatic steatosis
• hepatocellular carcinoma
• metastases from lipid-containing tumors like a liposarcoma
• lipopeliosis
• pseudocyst of the Glisson capsule

Other differentials considerations include:

• pericaval fat collection