Perikardzyste

Perikardzyste
in der Computertomographie: Zystische Läsion im perikardialen Fett mit Bezug zum Perikard, zarte Begrenzung, Dichtewerte um 20 HU, hier etwas gelappt. Nicht histologisch bestätigt, aber erste Differenzialdiagnose.
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CT Scan of
the thorax showing the pericardial cyst.
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A diagnostic
approach to the mediastinal masses. a Lateral chest radiograph of a 58-year-old smoker man allergic to iodine shows a well-defined mass (*) in the cardiophrenic space and a nodular lung opacity (open arrow) in the lower lung parenchyma. b, c Non-contrast-enhanced CT scan confirms the presence of a fluid-attenuation mass (*) in the right cardiophrenic angle (pericardial cyst) and demonstrates a suspicious lung opacity (open arrows) in the right lower lobe of the lung (squamous-cell carcinoma)
insightsimaging.springeropen.com • CC-by-2.0
A diagnostic
approach to the mediastinal masses. A well-marginated mass with a homogeneous attenuation, usually in the range of water attenuation (0–20 HU) and without an enhancement of the wall or infiltrative appearance are the typical features of benign mediastinal cysts. Probably thymic cystic (a) and pericardial cyst (b)
insightsimaging.springeropen.com • CC-by-2.0
A diagnostic
approach to the mediastinal masses. Conventional radiograph can provide information pertaining to the size, anatomical location and density of a central mass. Right: Frontal chest radiograph shows a sharply defined area of increased opacity with a loss of the cardiac silhouette at the border of the right side of the heart (*). Contrast-enhanced CT scan reveals a thin-walled water-attenuation lesion (*) in the right cardiophrenic angle (pericardial cyst). Middle: Lateral chest radiograph and contrast-enhanced CT scan show a unilocular, well-defined and homogeneously hypodense mass in the anterior mediastinum with peripheral calcification (open arrows) (thymic cyst). Left: Chest radiograph shows the aortopulmonary window with an abnormal convex border (arrow). Contrast-enhanced CT scan demonstrates a multilobulated mass in the anterior mediastinum (arrow), which accounts for the distortion of the AP window (nodular sclerosis Hodgkin disease)
insightsimaging.springeropen.com • CC-by-2.0
Imaging of
congenital lung diseases presenting in the adulthood: a pictorial review. Differential diagnoses of bronchogenic cyst. Infected bullae on axial (a) and sagittal (b) CT images are observed. Esophageal duplication cyst on axial (c) and coronal (d) CT images, pericardial cyst on T2-weighted MRI (e) and axial CT image (f) and hydatid cyst on axial CT images (g, h) are considered in the differential diagnoses of bronchogenic cyst
insightsimaging.springeropen.com • CC-by-4.0
Pleuro-Pericardial
Cyst: A Case Report. A fluid density structure is noted adjacent to right side of the heart. The CT HU value of the lesion was between 2-10 HU. The ribs appeared normal. No other significant findings were noted.
www.eurorad.org • CC by-nc-sa-4.0
Kleine
Perikardzyste als Zufallsbefund im Röntgenbild des Thorax. Computertomographisch ebenfalls gut passend. Keine histologische Bestätigung.
Wikipedia • CC BY-SA 4.0
Perikardzyste
rechts dem Zwerchfell aufliegend mit Bezug zum Perikard. Der Befund wurde nicht histologisch gesichert, jedoch sind die Differenzialdiagnosen, insbesondere eine bronchogene Zyste bei fehlendem Bezug zum Tracheobronchialsystem und extrapulmonaler Lage unwahrscheinlich.
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Radiopaedia • CC-by-nc-sa 3.0 • de

Pericardial cysts are uncommon benign congenital anomalies of the anterior and middle mediastinum.

Clinical presentation

Usually asymptomatic and discovered incidentally although occasionally may present with chest pain and dyspnea.

Pathology

They are thought to often result from aberrations in the formation of celomic cavities. They can occur as sequelae of previous pericarditis. The cyst wall is composed of connective tissue and a single layer of mesothelial cells, and usually contains clear fluid.

Location

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

Variants

Radiographic features

Plain radiograph

Typically seen as a mass-like density at the cardiophrenic sulcus. They can be of different shapes and are not always round. May change in shape and size with inspiration and position.

CT

Usually appears as a well-defined, non-enhancing, fluid-attenuation, rounded mass next to the pericardium.

MRI

Morphology again can be variable. Internal septations may be present. Signal characteristics are those of fluid and include :

  • T1: typically low signal (occasionally can be high signal if contains proteinaceous material)
  • T2: high signal
  • T1 C+ (Gd): no enhancement

Treatment and prognosis

They are benign lesions. Surgical resection or aspiration may be performed for symptomatic selected cases.

Differential diagnosis

As general differential on cross-sectional imaging

On a chest radiograph also consider:

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Perikardzyste:
Bronchogene
Zyste
pediatricimaging.org • CC-by-nc-sa 4.0
cystic
mediastinal masses
Wikipedia • CC BY-SA 4.0
mediastinales
Teratom
Wikipedia • CC BY-SA 4.0
Perikarditis
 
Wikipedia • CC BY-SA 4.0
primäre
Thymusneoplasien
ejb.springeropen.com • CC-by-4.0
Morgagni-Hernie
 
Wikipedia • CC BY-SA 4.0
perikardiale
Ausläufer
www.ncbi.nlm.nih.gov • CC-by-nc-4.0