Ultrasound in Diagnosis of Parapericardial Masses

Abstract

To the Editor.— Richard O. Friday, MD (226:82, 1973), described the ultrasound B scan as an aid in the diagnosis of pericardial cysts. We wish to point out that lesions appearing cystic by ultrasound B scan may not always be fluid filled. Report of a Case.— A 20-year-old white asymptomatic woman was seen in consultation because of an abnormal chest roentgenogram. A smooth, sharply demarcated circumscribed mass measuring 12 cm in diameter was identified at the right anterior aspect of the heart. Fluoroscopic examination showed a narrow pedicle. The mass was not pulsatile. The roentgenographic impression was a pericardial cyst. It was later noted that mediastinal widening was present (Fig 1). An ultrasound B scan examination revealed that the right paracardiac mass had excellent through-transmission at low gain, which exceeded that of the heart. The far border of the mass was smooth and no internal echoes were noted at medium