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Migrating Pericardial Cyst Mimicking a Pleural Pseudotumor
Christine J Ha1, Pierre D Maldjian1
1Department of Radiology, Rutgers New Jersey Medical School, Newark, New Jersey, United States.
Journal of Clinical Imaging Science
|June 18, 2020
Summary
A mobile pericardial cyst mimicked a pleural pseudotumor but shifted position when the patient changed from supine to decubitus. Computed tomography in the decubitus position aids differentiation of mobile pericardial cysts.
Area of Science:
- Cardiology
- Radiology
- Thoracic Surgery
Background:
- Pericardial cysts are rare congenital anomalies, typically located at the cardiophrenic angle.
- Atypical presentations can pose diagnostic challenges, potentially mimicking other thoracic lesions.
Observation:
- A mobile lesion was observed extending into the right pulmonary major fissure.
- In the supine position, the lesion mimicked a pleural pseudotumor along the right oblique fissure.
- Upon repositioning to the left lateral decubitus position, the lesion migrated to the right cardiophrenic angle.
Findings:
- Surgical exploration revealed a stalk connecting the cyst to the pericardium, explaining its mobility.
- The cyst's migratory behavior was directly correlated with patient positioning.
- Computed tomography (CT) scanning in decubitus position demonstrated characteristic features of a mobile pericardial cyst.
Implications:
- This case highlights the importance of patient positioning during CT imaging for diagnosing mobile pericardial cysts.
- CT scanning in the decubitus position is a valuable tool for differentiating mobile pericardial cysts from pleural pseudotumors.
- Understanding the anatomical basis of cyst mobility can improve diagnostic accuracy and guide surgical planning.
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