Pericardial cyst

A pericardial cyst is an uncommon benign congenital anomaly of the middle mediastinum. They can occur as sequelae of previous pericarditis.

Clinical presentation

Most patients are asymptomatic and therefore discovered incidentally.

Location

They are preferentially found in the right anterior cardiophrenic angle, but can be found almost anywhere adjacent to the heart. They occur more commonly on the right side.

Radiographic features

Plain film (CXR)

Typically seen as a mass (added density) at the cardiophrenic sulcus. May change in shape and size with inspiration and position.

CT

Usually appears as a well-defined, nonenhancing, low (water) attenuating, rounded mass next to the pericardium

Differential diagnoses

* see cystic mediastinal masses
* for chest radiograph
o pericardial fat pad
o thymic lesion
o mediastinal teratoma
o Morgagni hernia

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A rounded density with a smooth border in the region of the right cardiophrenic angle that partially obscures the right border of the heart. This turned out to be a pericardial cyst.

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A rounded density with a smooth border summates with the anterior heart. This turned out to be a pericardial cyst.

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Axial CT of the chest reveals a well-defined cystic structure measuring approximately 3.5 cm in diameter located in the right cardiophrenic angle, abutting the right heart border. This is most likely a pericardial cyst.

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Pericardial Cyst in pregnant female - MRI T2 Sag

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Pericardial Cyst X-ray

Article Author : Behrang Amini, MD/PhD, Radiopaedia

References

* 1. Jeung MY, Gasser B, Gangi A, Bogorin A, Charneau D, Wihlm JM, Dietemann JL, Roy C. Imaging of cystic masses of the mediastinum. Radiographics. 2002;22 Spec No:S79-93. PubMed
* 2. Reza Aghamohammadzadeh et.al, A patient with a large pericardial cyst, BMJ Case Reports 2009; doi:10.1136/bcr.06.2008.0046
* 3. Patel J, Pericardial cyst: case reports and a literature review. Echocardiography. 2004 Apr;21(3):269-72.

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