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Cardiovascular Imaging

Cyst, pericardial

fluid-containing thin-walled mass completely separate from the pericardium but composed of the same tissue. It usually contains simple fluid but in about 30% of instances contains viscous highly proteinaceous fluid. The cyst is most frequently located at the right costophrenic angle but may occupy other sites including the left costophrenic angle, or right or left sides of the middle and superior mediastinum.

Chest X-ray typically shows a smoothly and sharply marginated mass in the right costophrenic angle (Fig.1). Infrequently, the mass may be lobulated. CT and MRI demonstrate the fluid filled mass with thin capsule. Infrequently, the fluid is high density on CT or high intensity on T1-weighted spin echo MRI.

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Fig.1

Chest radiograph shows a hemispherical mass in the right cortophrenic angle.
Cyst, pericardial, Fig.1