CTICasesPericardial Cyst in the Major Fissure
Imaging findings
Serial chest radiographs show an enlarging, smoothly marginated mass in the right middle/lower lung zone, mimicking a Morgagni hernia or lung tumor. CT chest shows a homogeneous, thin-walled, water-attenuation structure located within the right major fissure, communicating with the pericardial space.
Key takeaways
Pericardial cysts are benign, congenital fluid-filled structures. Because they are flaccid and thin-walled, negative pleural pressure can cause them to herniate or invaginate into the pulmonary fissures (especially the major fissure). This creates a pseudomass appearance on radiographs that changes in shape or size depending on patient position.
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