Learning Radiology xray montage

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)
    • DDX of a right cardiophrenic angle mass
      • Pericardial cyst
      • Sequestration
      • Foramen of Morgagni hernia
  • They can occur higher and may extend into major fissure
    • Classically they are soft and can be flattened on the edge that faces the fissure
  • They rarely occur in the mediastinum
  • Imaging findings
    • Sharply marginated
    • Round or oval mass
    • From 3-8 cm in size usually
    • They can change in size and shape with respiration or body position
    • Rarely calcify
  • On CT, their attenuation values of 20-40 HU, occasionally higher 


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.