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Mediastinum

Cystic lesions

Pericardial cyst


Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 24 February 2013, last major update December 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Usually at right cardiophrenic angle, adherent to pericardium and diaphragm; may communicate with pericardial cavity
● Due to failure of one of multiple disconnected lacunae to merge with the others

Clinical features
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● Usually asymptomatic patients of all ages anywhere in mediastinum; rarely associated with dyspnea or chest pain

Case reports
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● 30 year old man with large cyst and pericarditis (Ann Thorac Surg 2009;88:e11)

Xray description
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● Irregular, adjacent to cardiac contour

Gross description
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● Thin fibrous wall, unilocular, collapses when opened, smooth cyst lining, serous fluid contents

Micro description
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● Fibrous tissue lined by bland mesothelium, rarely with papillary hyperplasia, no cholesterol granulomas, no smooth muscle, no cartilage, no specialized epithelium

Micro images
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Cyst wall composed of thin layer of fibrous tissue lined with single layer of mesothelial cells

Positive stains
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● Keratin

End of Mediastinum > Cystic lesions > Pericardial cyst


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