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Aires Martins II, Costa Correia B, Morais Pimenta SA, Gomes Gracio Dos Reis AC. Mediastinal Enlargement in an 8-Year-Old Child: What Could Be Causing It? ACTA MEDICA PORT 2024; 37:289-290. [PMID: 38631053 DOI: 10.20344/amp.20727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/08/2023] [Indexed: 04/19/2024]
Affiliation(s)
- Inês Isabel Aires Martins
- Pediatrics Department. Centro Materno-Infantil do Norte Albino Aroso. Centro Hospitalar Universitário do Porto. Porto. Portugal
| | - Bárbara Costa Correia
- Pediatrics and Neonatology Department. Centro Hospitalar do Tâmega e Sousa. Guilhufe. Portugal
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2
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Zhang WM, Maimaitiaili A, Aizezi R, Abulimiti K, Yan F, Huo Q. Surgical Management of Pericardial Cysts: A Single-Center Retrospective Study. Cureus 2023; 15:e49298. [PMID: 38957189 PMCID: PMC11218600 DOI: 10.7759/cureus.49298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 07/04/2024] Open
Abstract
Introduction Pericardial cysts (PCs) are infrequent, non-malignant, and congenital abnormalities. The identification and treatment of PCs remain a significant challenge, with limited research on surgical management. Methods We performed a retrospective study of patients with PCs who underwent surgical intervention at the First Affiliated Hospital of Xinjiang Medical University from February 2002 to December 2022. Results A total of 55 patients underwent surgery due to PCs during the study period. Thirty-one were females and 24 were males. The average age of the patients was 44.7 ± 12.9 (six to 63 years old). PCs were located in the right hemithorax in 50 (90.9%) patients and left hemithorax in five (9.1%) patients. Approach methods were video-assisted thoracoscopic surgery (VATS) in 43 (78.2%) cases; thoracotomy in 11 (20%) cases, and median sternotomy in one (1.8%) cases. The average postoperative hospitalization period was 5.6 days (two to 14 days). Three patients developed postoperative complications (two pleural effusion, one pneumonia), whereas no mortality was observed in any patient due to the operation. Forty-one patients (74.5%) were followed up for three months to eight years postoperatively, during which no recurrent cysts were detected. Conclusion In this single-center retrospective study, we demonstrated that pericardial cyst cure is an appropriate operation according to cyst characteristics. VATS has been shown to be highly effective and safe in patients with PCs, offering the advantage of reducing postoperative morbidity efficiently.
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Affiliation(s)
- Wei-Min Zhang
- Department of Cardiac Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, CHN
| | - Abdunabi Maimaitiaili
- Department of Cardiac Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, CHN
| | - Rehemutulajiang Aizezi
- Department of Cardiac Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, CHN
| | - Kadeyanmu Abulimiti
- Department of Cardiac Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, CHN
| | - Fei Yan
- Department of Cardiac Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, CHN
| | - Qiang Huo
- Department of Cardiac Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, CHN
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3
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Chalhoub G, Kamel A, Levsky J, Schenone A, Garcia MJ. A Large Cyst in an Unlikely Location: The Interventricular Septum. CASE (PHILADELPHIA, PA.) 2023; 7:401-404. [PMID: 37970483 PMCID: PMC10635888 DOI: 10.1016/j.case.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
•A large cardiac cyst was discovered in an extremely rare location: the IVS. •Pre- and postcontrast imaging is essential in the evaluation of a cystic mass. •When identifying a cardiac cyst, malignancy and infection must be considered. •The benefit of excising a cardiac cyst is unclear in an asymptomatic older patient.
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Affiliation(s)
- George Chalhoub
- Department of Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Andrew Kamel
- Department of Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Jeffrey Levsky
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Aldo Schenone
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Mario J. Garcia
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
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4
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Sheridan JA, Noga M, Mackie AS. Congenital Disorders of the Pericardium. Can J Cardiol 2023; 39:1140-1143. [PMID: 36931623 DOI: 10.1016/j.cjca.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023] Open
Affiliation(s)
- Jared A Sheridan
- Stollery Children's Hospital and Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle Noga
- Stollery Children's Hospital and Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Andrew S Mackie
- Stollery Children's Hospital and Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
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5
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Kurmann R, El-Am E, Ahmad A, Abbasi MA, Mazur P, Akiki E, Anand V, Herrmann J, Casanegra AI, Young P, Crestanello J, Bois MC, Maleszewski JJ, Klarich K. Cardiac Masses Discovered by Echocardiogram; What to Do Next? STRUCTURAL HEART : THE JOURNAL OF THE HEART TEAM 2023; 7:100154. [PMID: 37520139 PMCID: PMC10382990 DOI: 10.1016/j.shj.2022.100154] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/06/2022] [Accepted: 12/21/2022] [Indexed: 02/12/2023]
Abstract
Cardiac tumors are rare conditions, typically diagnosed on autopsy, but with the advancement of imaging techniques they are now encountered more frequently in clinical practice. Echocardiography is often the initial method of investigation for cardiac masses and provides a quick and valuable springboard for their characterization. While some cardiac masses can be readily identified by echocardiography alone, several require incorporation of multiple data points to reach diagnostic certainty. Herein, we will provide an overview of the main clinical, diagnostic, and therapeutic characteristics of cardiac masses within the framework of their location.
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Affiliation(s)
- Reto Kurmann
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Edward El-Am
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ali Ahmad
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Piotr Mazur
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Elias Akiki
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Vidhu Anand
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Joerg Herrmann
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ana I. Casanegra
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Phillip Young
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Juan Crestanello
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Melanie C. Bois
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joseph J. Maleszewski
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kyle Klarich
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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6
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Wang X, Zhang W, Wang M, Jiao R. Prenatal ultrasound diagnosis of fetal giant pericardial cyst: A case report. Medicine (Baltimore) 2023; 102:e34119. [PMID: 37352036 PMCID: PMC10289504 DOI: 10.1097/md.0000000000034119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 06/25/2023] Open
Abstract
RATIONALE We describe 1 case of fetal giant pericardial cyst was diagnosed by fetal echocardiography in the second trimester, and the changes of the cyst were recorded by follow-up observation in the late trimester and after birth. We then review and discuss the knowledge about its diagnosis and treatment. PATIENT CONCERNS A 34-year-old pregnant woman was referred to our hospital because of a diagnosis of a fetal pericardial effusion at 22 5/7 weeks at another hospital. DIAGNOSIS Fetal echocardiography revealed an irregular anechoic area in the right side of the fetal right atrium and right ventricle that was closely related to but not communicated with the pericardiumis and suggested fetal pericardial cyst. Fetal cardiothoracic magnetic resonance imaging showed cystic FIESTA signal in the right lung region, with clear boundary, and a seemingly line-like low signal shadow within. INTERVENTIONS Since fetal pericardial cysts keep decreasing in size during maternal pregnancy, follow-up observation measures are taken. OUTCOMES Fetal pericardial cysts disappear on their own 4 months after delivery. LESSONS Asymptomatic pericardial cysts in the fetal period can be followed up and observed, and intervention is performed only when the cyst rapidly enlarges or ruptures and becomes infected in the fetal or neonatal period. Echocardiography can be used as a first-line detection method for their initial detection and follow-up.
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Affiliation(s)
- Xiaoqing Wang
- Hebei Medical University, Shijiazhuang, China
- Department of Ultrasound, Hebei General Hospital, Shijiazhuang, China
| | - Weixia Zhang
- Department of Ultrasound, Hebei General Hospital, Shijiazhuang, China
| | - Mijie Wang
- Department of Ultrasound, Hebei General Hospital, Shijiazhuang, China
| | - Ronghong Jiao
- Department of Ultrasound, Hebei General Hospital, Shijiazhuang, China
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Li M, Yang C, Li J, Jia D, Wang Y, Xie W, Wang J. A large pericardial cyst mimicking a unilateral pleural effusion: A case report. Medicine (Baltimore) 2023; 102:e33540. [PMID: 37058028 PMCID: PMC10101316 DOI: 10.1097/md.0000000000033540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/27/2023] [Indexed: 04/15/2023] Open
Abstract
RATIONALE Pericardial cysts are a rare benign disorder with a variable clinical presentation depending on their size and location. The diagnosis of pericardial cysts is usually based on imaging examinations. The definitive treatment is surgical resection. PATIENT CONCERN A 36-year-old woman presented with progressive left-sided chest pain and exertional dyspnea, with symptoms resembling pleural effusion. DIAGNOSES The patient was diagnosed with a pericardial cyst based on imaging and video-assisted thoracoscopic surgery (VATS). INTERVENTION VATS was performed. OUTCOMES The patient's symptoms improved after successful removal of the pericardial cyst. Follow-up chest computed tomography exhibited no evidence of recurrence. LESSONS Clinicians should include pericardial cysts in the differential diagnosis of pseudopleural effusion. VATS is a feasible and safe method to treat symptomatic and large pericardial cysts.
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Affiliation(s)
- Minfang Li
- Department of Respiratory Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
- The Second School of Clinical Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunfeng Yang
- Department of Respiratory Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
- The Fourth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Jinshuai Li
- Department of Respiratory Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
- The Fourth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Dan Jia
- Department of Respiratory Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Yaqiong Wang
- Department of Respiratory Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Wei Xie
- Department of Respiratory Medicine, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| | - Jinlin Wang
- Department of Respiratory Disease, The State Key Laboratory of Respiratory Disease, China Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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8
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Kim JH, Choe J, Kim HK, Lee HY. MRI-Based Stepwise Approach to Anterior Mediastinal Cystic Lesions for Diagnosis and Further Management. Korean J Radiol 2023; 24:62-78. [PMID: 36606621 PMCID: PMC9830146 DOI: 10.3348/kjr.2022.0606] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/06/2022] [Accepted: 10/22/2022] [Indexed: 01/03/2023] Open
Abstract
As the majority of incidentally detected lesions in the anterior mediastinum is small nodules with soft tissue appearance, the differential diagnosis has typically included thymic neoplasm and prevascular lymph node, with benign cyst. Overestimation or misinterpretation of these lesions can lead to unnecessary surgery for ultimately benign conditions. nonsurgical anterior mediastinal lesions. The pitfalls of MRI evaluation for anterior mediastinal cystic lesions are as follows: first, we acknowledge the limitation of T2-weighted images for evaluating benign cystic lesions. Due to variable contents within benign cystic lesions, such as hemorrhage, T2 signal intensity may be variable. Second, owing to extensive necrosis and cystic changes, the T2 shine-through effect may be seen on diffusion-weighted images (DWI), and small solid portions might be missed on enhanced images. Therefore, both enhancement and DWI with apparent diffusion coefficient values should be considered. An algorithm will be suggested for the diagnostic evaluation of anterior mediastinal cystic lesions, and finally, a management strategy based on MRI features will be suggested.
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Affiliation(s)
- Jong Hee Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jooae Choe
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hong Kwan Kim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ho Yun Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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9
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Kyvetos A, Panayiotou S, Voukelatou P, Papavasileiou G, Vrettos I. A Case of an Inflamed Pericardial Cyst As the Cause of Acute Onset Chest Pain in a Young Patient and Review of the Literature. Cureus 2022; 14:e23961. [PMID: 35547408 PMCID: PMC9085654 DOI: 10.7759/cureus.23961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2022] [Indexed: 11/26/2022] Open
Abstract
Among the extensive variety of disorders that can cause chest pain are the complicated pericardial cysts, pathological entities that otherwise are asymptomatic. Here, we describe a 34-year-old male patient with a symptomatic pericardial cyst presenting at the emergency department with acute chest pain that woke him up about six hours prior to presentation. The work up for his acute chest pain revealed a well-defined, fluid-filled, rounded mass next to the pericardium on the right cardiophrenic angle and increased acute phase reactants. The cyst was surgically removed and the biopsy showed signs of intense inflammatory infiltration with negative culture of the fluid. The patient received intravenous antibiotics for two weeks with complete resolution of the symptoms and remained asymptomatic for about two months after surgical excision. Among other symptoms that may be induced from the presence of a pericardial cyst, the acute onset of chest pain, in this otherwise benign condition, probably indicates the existence of a complication such as rupture, inflammation, or hemorrhage. Careful exclusion of other etiologies of chest pain is mandatory as the surgical excision of a complicated pericardial cyst remains the only therapeutic option.
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10
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Horiguchi T, Nishikawa T, Shiokawa N, Imakiire R, Okamoto Y. Intermittent abdominal pain in cardiac tamponade due to pericardial cysts. Pediatr Int 2022; 64:e15056. [PMID: 35484907 DOI: 10.1111/ped.15056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/17/2021] [Accepted: 11/11/2021] [Indexed: 01/05/2023]
Affiliation(s)
- Tatushi Horiguchi
- Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takuro Nishikawa
- Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Naohiro Shiokawa
- Department of Pediatrics, Kagoshima City Hospital, Kagoshima, Japan
| | - Ryo Imakiire
- Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yasuhiro Okamoto
- Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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11
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Ugwu J, Hamilton R, Taskesen T, Osei K, Ghali M. A rapidly enlarging giant pericardial cyst resected by video-assisted thoracoscopic surgery (VATS): A case report. J Cardiol Cases 2021; 25:234-236. [DOI: 10.1016/j.jccase.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/08/2021] [Accepted: 10/09/2021] [Indexed: 10/19/2022] Open
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12
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Terry NLJ, Manapragada PP, Aziz MU, Singh SP. Review of pericardial disease on computed tomography. J Med Imaging Radiat Sci 2021; 52:S65-S77. [PMID: 34588141 DOI: 10.1016/j.jmir.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/23/2021] [Accepted: 09/10/2021] [Indexed: 10/20/2022]
Abstract
Echocardiography has long been the mainstay in the evaluation of cardiac and pericardial disease. As computed tomography (CT) has advanced, it has become a valuable partner in the imaging of the pericardium. The advantages of CT include a larger field of view, multiplanar reconstruction and increased discrimination between various soft tissues and fluids. CT is less operator dependent and can more easily, and reproducibly, image areas of the pericardium for which echocardiography has poor windows such as the right pericardium. The introduction of EKG gating has decreased cardiac motion artifact and can allow functional evaluation although echocardiography remains the primary source of real-time imaging of cardiac and valve motion. It is essential for the skilled cardiac imager to understand the strengths and weaknesses of CT and its role in the definition and assessment of pericardial disease.
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Affiliation(s)
- Nina L J Terry
- University of Alabama at Birmingham, Department of Radiology, Birmingham, AL, USA.
| | - Padma P Manapragada
- University of Alabama at Birmingham, Department of Radiology, Birmingham, AL, USA
| | - Muhammad Usman Aziz
- University of Alabama at Birmingham, Department of Radiology, Birmingham, AL, USA
| | - Satinder P Singh
- University of Alabama at Birmingham, Department of Radiology, Birmingham, AL, USA
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13
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Abstract
PURPOSE OF REVIEW Tumors of the pericardium are rare, but a wide variety of congenital, infectious, inflammatory, and neoplastic processes have been reported. Pericardial tumors can be categorized as non-neoplastic or neoplastic. Neoplastic lesions can be further divided into benign or malignant, with malignancies being either primary or secondary (metastatic). Clinical, radiographic, and pathologic features of the most common entities are discussed. RECENT FINDINGS Metastatic neoplasms involving the heart and pericardium are far more common than primary pericardial neoplasms. Of primary pericardial malignancies, mesothelioma is the most common; notably, cytology of effusion fluid is relatively insensitive to the diagnosis. The prognosis for most malignancies of the pericardium, primary or secondary, is poor. Increasingly, clinically recognized diseases that involve the pericardium include Erdheim-Chester and IgG4-related disease. This article provides a comprehensive review of the most recent literature to develop a structured framework to the differential diagnosis of pericardial tumors.
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14
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Alex A, Ayyappan A, Valakkada J, Pillai VV, Sreekantan R, Poyuran R. Pericardial pseudocyst along atrioventricular groove. BJR Case Rep 2020; 7:20200122. [PMID: 33841901 PMCID: PMC8008468 DOI: 10.1259/bjrcr.20200122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 11/22/2022] Open
Abstract
Cystic lesions in relation to the pericardium are a rare congenital lesion with an estimated incidence of 1 per 100,,000. Pericardial cysts may be classified as congenital or acquired. Here, we present a case of a pericardial pseudocyst having a horseshoe configuration along the atrioventricular groove in a middle-aged subject with no previous relevant medical history. The patient underwent open surgery for the same with histopathological diagnosis being established. This paper highlights the differentials for a cystic pericardial lesion in imaging in addition to the histopathological entity of a pericardial pseudocyst.
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Affiliation(s)
- Ajay Alex
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Anoop Ayyappan
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Jineesh Valakkada
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Vivek V Pillai
- Department of Cardiovascular & Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Renjith Sreekantan
- Department of Cardiovascular & Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Rajalakshmi Poyuran
- Department of Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
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15
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Stewart BD, VandenBussche CJ, Leon ME. Benign lesions of the mediastinum: A review with emphasis on cytology and small biopsy specimens. Semin Diagn Pathol 2020; 37:199-210. [PMID: 32534865 DOI: 10.1053/j.semdp.2020.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 04/01/2020] [Indexed: 01/03/2023]
Abstract
This review focuses on the diagnosis of select benign processes, ranging from reactive entities to heterotopic tissues to neoplasms, which may occur in the mediastinum. Currently, the mediastinum can be evaluated and biopsied with endoscopic procedures. Therefore, cytopathology specimens, fine needle aspirations, and small biopsies play an important role in the diagnosis of these lesions. In this review, an emphasis is given to relevant clinical presentations, histologic and cytologic findings, differential diagnoses, ancillary testing, and interpretation. Pitfalls are reviewed and discussed in each section. It is important for both surgical pathologists and cytopathologists to be familiar with these entities and their cytologic and histologic features that may be helpful in reaching a diagnosis.
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Affiliation(s)
- Brian D Stewart
- University of Florida College of Medicine Department of Pathology, Immunology and Laboratory Medicine P.O. Box 100275 1600 SW Archer Road Gainesville, FL 32610-0275.
| | - Christopher J VandenBussche
- Johns Hopkins University School of Medicine, Department of Pathology, 600 N. Wolfe Street Baltimore, MD 21287
| | - Marino E Leon
- University of Florida College of Medicine Department of Pathology, Immunology and Laboratory Medicine P.O. Box 100275 1600 SW Archer Road Gainesville, FL 32610-0275
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16
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Incekara F, Findik G, Turk İ, Erturk H, Aydogdu K, Apaydin SMK, Demiröz SM, Demirag F. Video-Assisted Thoracoscopic Treatment of Coelomic Cysts. J Laparoendosc Adv Surg Tech A 2020; 30:553-557. [PMID: 32182161 DOI: 10.1089/lap.2019.0799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Coelomic cysts are uncommon benign cyctic lesions of the mediastinum. Complete resection of the cyst with surgical treatment is indicated depending on whether the patient is symptomatic or whether the cyst grows during follow-up, or whether the diagnosis is uncertain. Surgical treatment prevents complications, relieves symptoms, and establishes diagnosis. Video-assisted thoracoscopic surgery (VATS) is the best method for excision of these cysts. This approach is safe and effective, has low morbidity, and shortens the length of hospital stay Objectives: We aimed to analyze our experience with coelomic cysts through VATS, reviewing clinical, radiological, and pathological features, early and long-term results of surgical management. Patients and Methods: Between January 2011 and December 2018, 20 patients with coelomic cysts who underwent VATS at our clinic were included in the study. Results: The study included 11 female and 9 male patients with a mean age of 45.6 years. Symptoms were present in 17 patients and 3 were asymptomatic. The average cyst diameter was 5.4 cm (range 2-8 cm). Fourteen of them were right sided, the others were left sided. There were no operative mortality and complications. Postoperatively there were no complications, in all cases course was uneventful, all of them were discharged after a mean of 3 days (range 2-6 days). Conclusions: Considering the low complication rate and hospital stay, excision of coelomic cysts through VATS is extremely safe and comfortable, so it should be considered the primary therapeutic procedure.
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Affiliation(s)
- Funda Incekara
- Department of Thoracic Surgery, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Gokturk Findik
- Department of Thoracic Surgery, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - İlteris Turk
- Department of Thoracic Surgery, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Hakan Erturk
- Department of Radiology, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Koray Aydogdu
- Department of Thoracic Surgery, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Selma Mine Kara Apaydin
- Department of Thoracic Surgery, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Sevki Mustafa Demiröz
- Department of Thoracic Surgery, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Funda Demirag
- Department of Pathology, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
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When and why was the phrenicoabdominal branch of the left phrenic nerve placed into the esophageal hiatus in German textbooks of anatomy? An anatomical study on 400 specimens reevaluating its course through the diaphragm. Ann Anat 2020; 227:151415. [DOI: 10.1016/j.aanat.2019.151415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/04/2019] [Accepted: 08/13/2019] [Indexed: 11/20/2022]
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Pericardial cyst on the left heart border. Neth Heart J 2019; 27:583-584. [PMID: 31197749 PMCID: PMC6823344 DOI: 10.1007/s12471-019-1301-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Abstract
PURPOSE OF REVIEW This is an in-depth review on the etiology, clinical manifestation, differential diagnosis, diagnostic modalities, complications, and management of pericardial cysts (PCs). RECENT FINDINGS PCs are the third most common type of mediastinal masses and are usually identified incidentally by chest x-ray (CXR) or transthoracic echocardiography (TTE). Although most PCs are asymptomatic, they might lead to serious complications such as cardiac tamponade. Diagnosis is confirmed by cardiac computed tomography or cardiac magnetic resonance. Cysts need to be followed by imaging every 1 to 2 years; however, a recent report suggested less frequent follow-up. Most cases resolve spontaneously, but if needed, aspiration or surgical resection can be done. PCs are rare entities and are usually detected incidentally after CXR or TTE. Providers should be aware of this condition since it could potentially lead to serious complications.
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Affiliation(s)
- Mohamed Khayata
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Saqer Alkharabsheh
- Center for the Diagnosis and Treatment of Pericardial Disease, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Nishant P Shah
- Center for the Diagnosis and Treatment of Pericardial Disease, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Allan L Klein
- Center for the Diagnosis and Treatment of Pericardial Disease, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
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