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Prominent Pericardial Recess Mimicking Mediastinal Lymphadenopathy

Imaging findings

An unusually large, multilobulated pericardial recess is seen enveloping the right inferior pulmonary vein.

Key takeaways

A small pericardial recess along the right inferior pulmonary vein can be seen even without a pericardial effusion elsewhere and is a recognized pitfall that can be mistaken for mediastinal lymphadenopathy. This example was strikingly large and multilobulated, serving as a reminder to recognize this normal anatomic recess rather than raising concern for a sinister process.

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