Pericardial Cyst Research Articles

Recurrent cardiac hydatid cyst located near the root of the superior vena cava and the interatrial septum: a case report

Introduction: Cardiac localization of hydatid disease is rare (<3%) even in endemic countries. Affection characterized by a long functional tolerance and a large clinical and paraclinical polymorphism. Serious cardiac hydatitosis because of the risk of rupture requiring urgent surgery. The diagnosis is based on serology and echocardiography. The aim of this work is to show a case of recurrent cardiac hydatid cyst discovered incidentally during a facial paralysis assessment. Methods: We report the observation of a 26-year-old woman operated on in 2012 for pericardial hydatid cyst presenting a cardiac hydatid cyst located near the abutment of the SCV discovered incidentally during an exploration for left facial paralysis: NYHA stage II dyspnea. Chest x-ray: CTI at 0.48. ECG: RSR. Echocardiography: Image of cystic appearance at the level of the abutment of the SVC. SAPP: 38 mmhg, EF: 65%. Thoracic scan: 30/27 mm cardiac hydatid cyst bulging the lateral wall of the right atrium and the trunk of the right pulmonary artery with fissured cardiac hydatid cyst of the apical segment of the right lung of the right lower lobe with multiple bilateral intra parenchymal and sub pleural nodules. The patient was operated on under CPB. Intraoperative exploration: Presence of a hard and whitish mass, about 03 / 03cm developed in the full right atrial wall opposite the entrance to the superior vena cava. Procedure: Resection of the mass removing the roof of the LA, the AIS and the wall of the RA with reconstruction of the roof of the RA by patch in Dacron and reconstruction of the IAS and the wall of the RA by a single patch in Dacron. Results: The postoperative suites were simple. Conclusion: The hydatid cyst is still a real endemic in Algeria, the cardiac location is rare but serious and can constitute a real surgical emergency, hence the importance of prevention. Keywords: Hydatid cyst of the heart; Recurrence; Surgery; Cardiopulmonary Bypass; Prevention

A HUGE PERICARDIAL CYST MIMICKING A FALSE LEFT DIAPHRAGMATIC PARALYSIS

Pericardial cysts are infrequent mediastinal entities. They can mimic cardiac chamber enlargement, phrenic hernia, malignancy, bronchogenic cysts, pleurisy, dextrocardia. Diaphragmatic elevation can also be misdiagnosed in some cases. The reports about huge pericardial cyst mimicking the left diaphragmatic elevation (paralysis) are not common. The correct diagnosis of pericardial cyst can be difficult due to unremarkable complains and non-specific findings on chest radiography. In this report we have presented a rare clinical case described as the huge pericardial cyst mimicking a false left diaphragmatic paralysis. The combination of different radiological technics (CT-scans, barium esophago-gastrography etc.) are useful to correct preoperative diagnosis. Transthoracic (intercostal) accesses are the dominant to operate on patients with huge pericardial cysts.

Intermittent abdominal pain in cardiac tamponade due to pericardial cysts.

Pediatrics InternationalVolume 64, Issue 1 e15056 Clinical Notes Intermittent abdominal pain in cardiac tamponade due to pericardial cysts Tatushi Horiguchi, Tatushi Horiguchi Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, JapanSearch for more papers by this authorTakuro Nishikawa, Corresponding Author Takuro Nishikawa adu44150@ams.odn.ne.jp orcid.org/0000-0001-5012-0906 Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan Correspondence: Takuro Nishikawa, MD, Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, 890-8520, Japan. Email: adu44150@ams.odn.ne.jpSearch for more papers by this authorNaohiro Shiokawa, Naohiro Shiokawa Department of Pediatrics, Kagoshima City Hospital, Kagoshima, JapanSearch for more papers by this authorRyo Imakiire, Ryo Imakiire Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, JapanSearch for more papers by this authorYasuhiro Okamoto, Yasuhiro Okamoto orcid.org/0000-0003-4412-6441 Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, JapanSearch for more papers by this author Tatushi Horiguchi, Tatushi Horiguchi Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, JapanSearch for more papers by this authorTakuro Nishikawa, Corresponding Author Takuro Nishikawa adu44150@ams.odn.ne.jp orcid.org/0000-0001-5012-0906 Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan Correspondence: Takuro Nishikawa, MD, Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, 890-8520, Japan. Email: adu44150@ams.odn.ne.jpSearch for more papers by this authorNaohiro Shiokawa, Naohiro Shiokawa Department of Pediatrics, Kagoshima City Hospital, Kagoshima, JapanSearch for more papers by this authorRyo Imakiire, Ryo Imakiire Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, JapanSearch for more papers by this authorYasuhiro Okamoto, Yasuhiro Okamoto orcid.org/0000-0003-4412-6441 Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, JapanSearch for more papers by this author First published: 28 April 2022 https://doi.org/10.1111/ped.15056Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume64, Issue1January/December 2022e15056 RelatedInformation

Concurrent Large Pericardial Cyst with Giant Thoracic Aortic Aneurysm-Presentation and Natural Evolution.

We report the first case of a patient with large pericardial cyst occurring concurrently with a very large thoracic aortic aneurysm. There have been no patients reported in the literature with this constellation of syndromes. Additionally, this case was followed through a period of 4 years, enabling the natural evolution of both pathologies to be visualised.

MEDIASTINAL MASS-INDUCED T WAVE INVERSION: FROM A ROUTINE EKG TO A MEDIASTINAL MASS

TOPIC: Cardiovascular Disease TYPE: Medical Student/Resident Case Reports INTRODUCTION: T-wave inversion (TWI) is a negative T-wave of ≥1 mm in depth in two or more contiguous leads, with exclusion of leads aVR, III, and V1[1]. TWI has a wide differential diagnosis that can range from benign causes including normal variants to life-threatening causes including coronary artery disease and rarely can be related to non-cardiac causes [1]. CASE PRESENTATION: Our patient is an 18-years-old female with a past medical history of asthma and major depressive disorder. She presented to the psych emergency department (ED) because of suicidal attempts. Patient complaints of worsening feelings of sadness, loss of interest, and decreased energy. Also, she reported having suicidal ideations. Review of systems was unremarkable She was vitally stable. On physical examinations, lungs were clear to auscultation, cardiovascular exam of normal heart sounds, no murmurs or gallops. Labs were within normal limits, including electrolytes, TSH, D-Dimer, and cardiac enzymes. The routine evaluation protocol in the psych ED includes Electrocardiogram (EKG) mainly to look for QTC intervals, as many of the medications that are used for the psych population may alter the QTC interval. Her EKG showed sinus rhythm with T wave inversion in leads II, III, aVF, and V3-V6 with QTc of 483; there were no previous EKGs for comparison. The EKG was repeated on different days and showed the same findings. The patient reported no family history of cardiovascular diseases. Cardiology was consulted, an echocardiogram showed a large extracardiac mediastinal mass which appears to press on the right ventricle; otherwise, ejection fraction was normal, and no significant valvular disease was observed. A computerized tomography scan of the chest revealed a large, 12 x 7 x 6 cm mediastinal mass along the inferior wall of the heart, exerting mass effect and displacing the heart superiorly. The patient was discharged and referred to a cardiothoracic surgeon for further evaluation. DISCUSSION: Different clinical conditions can cause T-wave inversions, ranging from life-threatening events, such as acute coronary ischemia and pulmonary embolism, to entirely benign conditions[1]. The mediastinum is a potential space in the thoracic cavity that is subdivided into anterior, middle, posterior, and superior mediastinum to form a differential diagnosis for the lesion [2]. In our case, our patient was presented with Inferolateral TWI that was investigated and was found to have a lesion in the middle mediastinum that could be a pericardial cyst, bronchogenic cyst, esophageal implications cyst or lymph node enlargement that can be secondary to tuberculosis or sarcoidosis or histoplasmosis. CONCLUSIONS: This case highlights that inferolateral TWI should always be investigated thoroughly, including by imaging studies when the cause is not clear to prevent life threatening conditions. REFERENCE #1: Hayden GE, Brady WJ, Perron AD, Somers MP, Mattu A. Electrocardiographic T-wave inversion: differential diagnosis in the chest pain patient. Am J Emerg Med. 2002 May;20(3):252-62. doi: 10.1053/ajem.2002.32629. PMID: 11992349. REFERENCE #2: Mediastinum. In: Gurney JW, Winer-Muram HT, Stern EJ, et al, editors. Diagnostic imaging: chest. Section I. Salt Lake City (Utah): Amirsys; 2006 DISCLOSURES: No relevant relationships by Hasan Abuamsha, source=Web Response No relevant relationships by Abdul Rahman Al Armashi, source=Web Response No relevant relationships by Isaac Alsallamin, source=Web Response No relevant relationships by Ameed Bawwab, source=Web Response No relevant relationships by Eleonora Demyda, source=Web Response No relevant relationships by Faris Hammad, source=Web Response

What is the Role of Radiology in Cardiac Masses Imaging Findings of Different Diagnoses

Aim: Cardiac masses are rare and categorized as non-neoplastic and neoplastic. Different imaging methods play a vital role in the diagnosis and surgical planning of cardiac masses. Echocardiography is the primary method of mass detection. Computed tomography (CT) and magnetic resonance imaging (MRI) are used to detect and monitor cardiac masses. In this study, we aimed to evaluate the role of radiology in the detection of rare cardiac masses and treatment planning. Patients and Methods: Admission symptoms of five patients with cardiac masses detected in our radiology unit between 2018 and 2021, the imaging methods in which the lesions were determined, and whether the imaging findings were consistent with their patholo gical diagnosis were evaluated. Results: The masses of patients diagnosed with lymphoma, pleomorphic sarcoma, and hemangioma were larger than 3 cm. The margins of the malignant masses were ill-defined, and invasion into adjacent structures was seen. Cardiac hemangioma, pericardial cyst, and myxoma had diagnostic radiological findings. Conclusion: It is significant to know the imaging findings according to the pathological diagnosis of cardiac masses in patient management and treatment planning.

Contrast Echocardiography for the Detection of a Giant Right Coronary Artery Aneurysm: A Useful Diagnostic Tool

Coronary artery aneurysm is an uncommon condition defined as abnormal dilatation of the coronary artery. We report the case of a man admitted to the Emergency Department for suspected intestinal obstruction. At abdominal/thoracic Computed Tomography (CT) it was reported a suspected pericardial cyst. Contrast echocardiography showed a clear pattern of blood flow inside the mass with a probable origin at a very limited region where it was also possible to sample an ECG-synchronized system-diastolic Pulse-Wave (PW)-Doppler pattern, typical for a coronary artery flow. Our suspicion of a giant coronary artery aneurysm was then confirmed by coronary CT and coronary angiography. The patient was transferred to a Cardiac Surgery center where he underwent surgical treatment for the aneurysm. Most coronary aneurysms are clinically silent and are often incidentally detected. Coronary angiography is the ‘‘gold standard’’ for diagnosis and evaluation of coronary artery aneurysms. Among non-invasive diagnostic techniques, Computed Tomography Coronary Angiography is the best method for coronary artery anatomy and coronary abnormalities. However, echocardiography with the use of a contrast agent, a cost-effective non-radiation nature, and a widespread use method, maybe a reliable method to detect and characterize the masses, allowing a differential diagnosis. Learning objective 1. Recognition and evaluation of cardiac masses require first-line imaging methods such as echocardiography. 2. The use of additional non-invasive (cardiac CT or MRI) and/or invasive imaging methods are often required. 3. Contrast echocardiography may be helpful, as second-line imaging methods, to better characterize the mass and approach the correct diagnosis.

Multiple clustered dermatofibroma associated with asymptomatic pericardial cyst

Multiple clustered dermatofibroma associated with asymptomatic pericardial cyst

Pericardial Hydatidosis in a Young Boy

Persistent chest pain is an uncommon entity in adolescent population, with majority of cases having no discernible cardiac etiology. We report a young boy presenting with chest discomfort due to underlying large pericardial hydatid cyst. Initial diagnostic confirmation was based on classic echocardiographic features, including presence of sonographic water lily sign. Patient subsequently underwent successful surgical excision of cyst under cardiopulmonary bypass, along with perioperative antihelminthic and anti-inflammatory drug therapy. Patient continues to remain symptom free on follow-up, with no recurrence in cyst formation. This case highlights the high index of suspicion needed in diagnosing such atypical cardiac cysts, especially in patients from endemic zones.

Diagnostic value of echocardiography in paracardiac cystic lesions: 43 cases from one single medical center

Paracardial cystic lesions (PCLs) are rare, benign lesions and may occur in any part surrounding the heart. It covers a variety of pathological types, including pericardial cysts, thymic cysts, bronchogenic cysts and so on. The aim of this study was to summarize the diagnostic value of echocardiography in different pathological types of the PCLs. Echocardiographic features of 43 consecutive PCL patients treated at the Union Hospital from January 2002 to December 2017 were compared and analyzed with their surgical and pathological findings retrospectively. The PCLs included 19 pericardial cysts, 12 thymic cysts, 7 bronchogenic cysts, 3 cystic teratomas, 1 enteric cyst and 1 lymphangioma. Among them, 29 cases (67.4%) were accurately diagnosed by echocardiography and 14 cases (32.6%) were missed the diagnosis. All diagnosed cysts were showed as thin-walled, monolocular, echo-free structures without blood flow signals in echocardiographic images. 4 patients had compression of the heart and great vessels caused by cysts. In addition, 4 intracardiac lesions were diagnosed by echocardiography and the results were further confirmed in surgery. Echocardiography is of great value in the diagnosis of paracardiac cystic lesions as well as combined intracardiac lesions. Differential diagnosis could be mainly made based on the location of the lesions.

Pericardial cyst: revisited

Pericardial cysts are rare mediastinal abnormalities, which are usually congenital but may also be acquired after cardiothoracic surgery. Pericardial cysts are most commonly located at the cardiophrenic angle or, rarely, in the posterior or anterior superior mediastinum. The majority of pericardial cysts are asymptomatic and are found incidentally on imaging studies. Our case was an 18-year-old female with a diagnosis of ostium secundum atrial septal defect (ASD). She was planned for surgical closure of ASD. On the opening of the pericardium, a pericardial cyst of around 3.0×2.0-cm size, filled with clear fluid, was found in the aorta–pulmonary artery groove. Marsupialization of the cyst was done followed by routine direct suture closure of ASD. Postoperative recovery was uneventful, and the patient was discharged on the third postoperative day. Histopathology of tissue confirmed our diagnosis. Our aim to present this case report is to show an incidental finding of the pericardial cyst at a rare location and to discuss its perioperative implications.

Living with a pericardial hydatid cyst for 50 years

Isolated cardiac location is an uncommon presentation of echinococcosis and involvement of the pericardium is even rarer. It may lead to various complications or remain asymptomatic for a long time. We report a case of a 71-year-old woman with isolated pericardial hydatid cyst (without myocardial involvement) that observed with incidentally.

Both mediastinal and pericardial hydatidosis revealed by ST elevation acute coronary syndrome

Hydatidosis remains an endemic disease in some regions of the world, such as Tunisia. The liver and the lungs are the most common sites in adults. Mediastinal and pericardial hydatid cysts are very rare even in endemic areas and true incidence has not been described in the literature. We report the case of a 74-year-old woman with clinical, biological and electrocardiographic features of acute myocardial infraction. Two-dimensional echocardiography and detailed imaging revealed a mediastinal and pericardial hydatid cyst. The particularity of the clinical presentation, the complementary investigations as well as the management and follow-up of the patient are discussed. This case is of great interest since the rarity of concomitant hydatid cyst in two uncommon localizations: mediastinum and pericardium, and the unusual incidental discovery during a myocardial infarction.

Mesothelial Cysts.

Peritoneal mesothelial cysts have been reported under various terms, including benign cystic mesothelioma, usually in the form of case reports/series, whereas extraperitoneal cases are rarely reported. Our objective was to report the detailed characteristics of cystic lesions of the serosal cavities. We retrospectively examined the clinicopathologic findings of a series of mesothelial cystic lesions (n = 79). Most cases (n = 68, 86%) concerned the peritoneum, whereas 11 (14%) concerned the pericardium. No pleural cases were found. A total of 51 (64.5%) lesions were solitary, whereas 28 (35.5%) were multiple. Peritoneal lesions harbored a plump eosinophilic mesothelium and a loose connective stroma, whereas pericardial lesions showed a cuboidal/flattened mesothelium, collagenous stroma, intense inflammation, and other tissue types, like adipose and muscle tissue. Solitary peritoneal lesions are usually extrapelvic and found in older patients incidentally during other surgeries, whereas multiple lesions are found in younger patients and usually in the pelvis. The lesions show a benign clinical course with rare recurrences but no malignant transformation. Most mesothelial cysts are peritoneal and rarely pericardial. Peritoneal cysts differ from pericardial cysts. Peritoneal solitary lesions differ from multiple lesions, also suggesting their pathogenetic differences.

Giant Pericardial Cyst with Thymic and Pancreatic Tissue

Crailsheim Ingo1*, Krenbek Dagmar1, Bonatti Johannes1, Winkler Bernhard1 and Grabenwöger Martin1,2 Author Affiliations 1Department of Cardiac and Vascular Surgery, Vienna North Hospital and Karl Landsteiner Institute of Cardiovascular Surgical Research, Austria 2Sigmund Freud University, Medical Faculty, Vienna, Austria Received: November 06, 2020 | Published: November 18, 2020 Corresponding author: Ingo Crailsheim, Department of Cardiac and Vascular Surgery, Vienna North Hospital and Karl Landsteiner Institute of Cardiovascular Surgical Research, Austria DOI: 10.26717/BJSTR.2020.32.005181

Pulmonary Hamartoma, A Relatively Common Diagnosis with a Rare Presentation

Abstract Casestudy: Pulmonary hamartomas (PH) are the most common benign tumors of lung, accounting for 75% of all the benign tumors and 8% of all the pulmonary neoplasms. These lung tumors are generally solitary and are observed in middle-aged and older adults with the peak incidence during the sixth decade of life. PH presents as asymptomatic nodule, found incidentally on routine radiographs and CT scans. The majority of PH are located in the lung parenchyma. Endobronchial hamartomas occur much less frequently. An extremely rare presentation of Hamartoma as a mediastinal mass is also reported in the past. The present article reports a case of a 72-year-old female, presented to her primary care physician with the complains of right lower abdominal pain. CT scan of the abdomen and pelvis revealed a partially visualized right paracardiac /mediastinal lipomatous mass. Patient stated that she was informed about a pericardial cyst of about golf ball size, noticed on a routine radiograph 40 years ago. Further workup with CT chest angiography revealed an 8.6 x 5.6 x 5.6 cm mediastinal mass associated with the right heart border and the right cardiophrenic angle, abutting the right diaphragm as well as the medial pleural reflection. A differential diagnosis of teratoma, lipoma/liposarcoma, and hamartoma was considered. Patient underwent robotic assisted surgical resection of the mass which emanated from right lower lung lobe. The histologic features and immunoreactivity pattern were consistent with a benign pulmonary hamartoma. Approximately 90 percent of PH presents as a peripheral intraparenchymal nodule whereas endobronchial hamartoma occurs much less frequently and represents 1.4% - 10 % of PH. A few cases of pulmonary hamartomas presenting as a mediastinal mass have been reported in the past few decades. Here in we report such a case of pulmonary hamartoma presenting as a mediastinal mass.

Unusual giant multilocular mesothelial cyst of mediastinum

BackgroundIntrathoracic mesothelial cysts are congenital lesions induced by the abnormal development of the pericardial coelom. There have been a few reports of giant mesothelial cyst of the superior mediastinum, but the preferred treatment remains a controversial topic. We herein report a rare case of successful removal of giant mesothelial cyst that was incidentally detected during a medical checkup.Case presentationA 53-year-old man with a feeling of mild chest tightness was referred to our hospital for the evaluation of an abnormal shadow of the mediastinum on chest X-ray. Computed tomography showed a multilocular, homogenous, large cyst in the superior mediastinum measuring 18 cm in size without contrast enhancement and with spotty calcification, and magnetic resonance imaging showed a low intensity on T1-weighted images and high intensity on T2-weighted images. Therefore, a cystic thymoma, thymic cyst, lymphangioma, cystic teratoma or pericardial cyst was suspected as the preoperative diagnosis. Despite mild symptoms, the patient underwent total thymectomy under median sternotomy for an appropriate diagnosis and treatment. The pathological diagnosis was giant multilocular mesothelial cyst.ConclusionsIntrathoracic mesothelial cyst is a benign cyst and generally asymptomatic, but can sometimes induce critical chest clinical symptoms if untreated, depending on its size. In our case, complete surgical resection and a detailed pathological evaluation was effective for making the appropriate diagnosis and delivering treatment. In addition, an immunohistological evaluation is effective for diagnosing mesothelial cysts when it is difficult to distinguish the cyst from other cystic lesions.

FLIGHT RISK: BRONCHUS-ASSOCIATED LYMPHOID TISSUE IN A HEALTHY AVIATOR

SESSION TITLE: Fellows Lung Cancer Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: October 18-21, 2020 INTRODUCTION: Bronchus-associated lymphoid tissue (BALT) lymphoma is a rare marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT). The incidence of MALT worldwide is estimated to be up to 1% of primary pulmonary lymphomas, most commonly endobronchial.(1) Infectious pathogens, amyloid deposition, rheumatological diseases and smoking have all been associated with pulmonary MALT to varying degrees.(2) Treatment is patient-specific, and ranges from observation to chemotherapy, radiation therapy or resection, usually with a favorable prognosis.(3) CASE PRESENTATION: We present a case of an asymptomatic United States Marine Corps F/A-18 fighter jet aviator who was incidentally found to have BALT, first identified as a 5mm lesion during a CT scan for an unrelated pericardial cyst four years earlier. The most recent imaging demonstrated the lesion to be similar in size to previous annual studies. To avoid further unnecessary exposure to radiation for a stable endobronchial lesion, we offered an inspection flexible bronchoscopy which confirmed the presence of a raised flesh-colored, polypoid lesion located in the medial right bronchus intermedius. PET/CT was non-avid. The lesion was easily biopsied and sent for pathological examination. After the diagnosis, the patient successfully underwent involved-site radiation therapy. He went on to receive a waiver from his flight surgeon to return to flight duty without limitations. DISCUSSION: Our case of BALT was diagnosed after it was noted incidentally on CT. Its radiographic appearance was consistent with other cases in the literature.(4, 5) This case underscores the importance of investigating such stable-appearing, non-resolving endobronchial lesions. In this instance, an efficient time course from diagnosis to treatment allowed this aviator to be cleared to fly again. CONCLUSIONS: Bronchus-associated lesions have a wide differential diagnosis.(5) This case highlighted how pursuit of such lesions may have clinical benefit, such as this case, which positively impacted this patient’s military flying career.(4) Reference #1: Takeshi K, Daisuke H, et. al. Endobronchial Mucosa-associated Lymphoid Tissue Lymphoma: A Report of Two Cases and a Review of the Literature. Intern Med. 2018; 57: 2233-2236. Reference #2: William J, Variakojis D, et. al. Lymphoproliferative Disorders. Archives of Pathology & Laboratory Medicine. 2013; 137: 382–391. Reference #3: Hiraishi Y, Iikura M, et. al. Two tracheal BALT lymphoma patients successfully treated with chemotherapy including rituximab. Respiratory Investigations. 2014; 52: 144- 146. DISCLOSURES: No relevant relationships by Neil Partain, source=Web Response

Silence of a huge pericardial cyst.

Silence of a huge pericardial cyst.

Multiple congenital pericardial cysts mimicking pleural effusion on diagnostic imaging.

Multiple congenital pericardial cysts mimicking pleural effusion on diagnostic imaging.