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Pericardial cyst

Published online by Cambridge University Press:  25 February 2010

Andrew Planner
Affiliation:
John Radcliffe Hospital, Oxford
Mangerira Uthappa
Affiliation:
Stoke Mandeville Hospital
Rakesh Misra
Affiliation:
Buckinghamshire Hospitals NHS Trust
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Summary

Characteristics

  • These are congenital out-pouchings from the parietal pericardium.

  • Rarely communicate with the pericardial space. If the cysts communicate with the pericardial space they are referred to as pericardial diverticula.

  • Appear as well-defined oval mass attached to the pericardium usually in the right cardiophrenic angle.

Clinical features

  • The majority are asymptomatic, identified incidentally on routine imaging.

  • A few may describe chest pain or dyspnoea.

Radiological features

  • CXR – sharply marginated mass lesion usually in the right cardiophrenic region measuring 3–8 cm.

  • CT – the cyst is fluid attenuation (HU < 20).

  • MRI – confirms cystic nature of the lesion with high T2 signal. The pericardium can often be demonstrated on MR sequences, as a low signal pencil line surrounding the cyst.

Differential diagnosis

  • Foregut duplication cyst.

  • Primary or secondary lung neoplasm.

  • Mediastinal pleural metastasis.

Management

  • No active management required.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2007

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