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Pericardial Cyst

 

         Fluid-filled cysts of the parietal pericardium consisting of a single layer of mesothelial cells

         Usually discover at age 30-40 years, predominantly in males (3:2)

         Most are asymptomatic and incidental findings

         Atypical chest pain can occur

         They are usually (75%) located at the cardiophrenic angle almost always on the right (3:1)

o       DDX of a right cardiophrenic angle mass

         Pericardial cyst

         Sequestration

         Foramen of Morgagni hernia

         They can occur higher and may extend into major fissure

o       Classically they are soft and can be flattened on the edge that faces the fissure

         They rarely occur in the mediastinum

         Imaging findings

 


Pericardial Cyst.
Frontal and lateral views of the chest demonstrate a mass at the right cardiophrenic angle with rim-like calcification that indicates the calcification has formed in the wall of a hollow viscus. This is a characteristic location for a pericardial cyst, which is calcified in this case.
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o       Sharply marginated

o       Round or oval mass

o       From 3-8 cm in size usually

o       They can change in size and shape with respiration or body position

o       Rarely calcify

         On CT, their attenuation values of 20-40 HU, occasionally higher