Case
16. (16 Feb. 1998)
Diagnosis: Pericardial cyst (connected to superior
pericardial recess)
major differential diagnosis: bronchogenic cyst
The vast majority of mesothelial cysts (pericardial or
pleuropericardial) are probably congenital and result from aberrations
in the formation of the coelomic cavities. Grossly, the cysts are spherical
or oval in shape, thin-walled, and often translucent: the vast majority
are unilocular and contain clear or straw-colored fluid. Of the 72 cysts
reviewed by a Mayo Clinic group, 54 were in the cardiophrenic angles and
18 arose at a higher level: 11 of the latter cysts extended into the superior
mediastinum. In most cases they range in diameter from 3 to 8 cm but
rarely have been reported to be as small as 1 cm or as large as 28 cm.
Symptoms are almost invariably absent, most cysts being discovered on a
screening chest roentgenogram.
Return to Case 16. (16 Feb.
1998)