Pericardial diverticulum with unusual symptomatology

A 38-year-old male was suspected of having an enlarged pretracheal lymph node on chest CT scan. At mediastinoscopy, a cystic lesion was recognized, and showed repeated dilatation and contraction synchronously with the cardiac beat. Pneumopericardium was demonstrated by intraoperative pneumocystography. The cystic lesion was diagnosed as pericardial diverticulum. The diverticular wall was partially resected for drainage of the pericardial fluid. Mediastinoscopy as a less invasive procedure may be useful for the differential diagnosis of adenopathies, and in case of lesion such as a small pericardial diverticulum may allow treatment.

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Mediastinoscopic diagnosis and drainage of pericardial diverticulum —A case report—

Ohno

Yamasaki

Hatanaka

et al. 1998

Jpn J Thorac Caridovasc Surg

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Pericardial diverticula misdiagnosed as pericardial cysts

Money

Park

2015

The Journal of Thoracic and Cardiovascular Surgery

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Pericardial cysts, which result from complete closure of an embryonic pericardial defect, are believed to occur at a frequency of 1 in 100,000, based on a 1958 chest radiograph screening. 1 Surgery is routinely not recommended, unless obvious compression of adjacent organs is demonstrated. However, 10% of all cysts may be instead a pericardial diverticulum with a persistent connection to the pericardial space, not apparent from radiologic studies, and identified only at surgery. 2 These lesions may cause atypical symptoms that are relieved only after surgery, as demonstrated by this case report. CASE REPORT A 66-year-old retired biologist was diagnosed in 1984 with an ''enlarged fat pad,'' by chest radiograph. Chest computed tomography (CT) scans revealed a right, cardiophrenic, 2.5-cm, soft-tissue cystic mass that had increased to 7.3 cm by 2008 (Figure 1). Additional studies included:

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Detection of pericardial flow in black blood-prepared T2 HASTE sequence imaging: Differentiation between pericardial diverticulum and cyst

Yoon

Han

Kim

et al. 2022

Magnetic Resonance Imaging

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Pericardial diverticulum with unusual symptomatology

Cited by 3 publications

References 6 publications

Mediastinoscopic diagnosis and drainage of pericardial diverticulum —A case report—

Mediastinoscopic diagnosis and drainage of pericardial diverticulum —A case report—

Pericardial diverticula misdiagnosed as pericardial cysts

Detection of pericardial flow in black blood-prepared T2 HASTE sequence imaging: Differentiation between pericardial diverticulum and cyst

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