Pericardial cyst and which diseases are easily misdiagnosed?

Pericardial cyst is also a relatively common benign cyst located in the pericardium. It is a congenital mediastinal cyst, also called intersplenic cyst. If it occurs, it can cause great harm to health, especially since this part is relatively hidden. It is easy to misdiagnose during medical diagnosis and can be easily confused with bronchial cyst, dermoid cyst or esophageal cyst.

1Dermoid cyst

Most of them are located in the anterior and middle mediastinum. The mass has clear contours and sharp edges, but the density is uneven. The CT value is -10 to 10Hu. Calcification can be seen in 1/3 to half of them. They are connected with the bronchi and can form fluid-air cavities. Coughing up hair can help with differential diagnosis.

2 Bronchogenic cyst

It is common in the bronchi and around the bronchi. It is a round or oval watery shadow with uniform density and smooth and sharp edges. It is connected to the bronchi and can change in size with breathing. If it contains some liquid, it will form an air-fluid cyst. CT shows uniform density, thin cyst wall, and smooth inner edge. It can cause compression and narrowing of the adjacent trachea or bronchus. The CT value is 30 to 50Hu.

3. Esophageal cyst

The round or oval cystic mass located beside the esophagus in the anterior part of the posterior mediastinum has a smooth contour and a thick cystic wall >4mm, presenting as muscular soft tissue. The local esophagus is compressible and the CT value is about 50Hu.

4Pericardial fat pad

It is common in obese people with more left heart diaphragm angles and incomplete contours. The density is relatively lower than that of pericardial cysts. The lateral view is often unclear and the CT value is negative (below -50Hu). MRI is very sensitive in distinguishing between fat and watery substances. Fat pads appear as high signals on SE sequence TI-WI images.