Perikard kist: Olgu Sunumu

Nonneoplastik mediastinal kistler primer mediastinal lezyonların yaklaşık %20'sini oluştururken, bunların %20-30'unu perikardial kistler oluşturur. Genelde konjenital olan bu lezyonlar 4 ve 5'inci dekatta semptomatik hale gelirler. Konjenital perikardial kistler genelde asemptomatik olup rutin akciğer grafilerinde tesadüfen saptanırlar. Genellikle kardiofrenik açıda, özellikle sağ tarafta yerleşirler. Nadiren sol kostofrenik açıda, hilusta, arkus düzeyinde ve üst mediastende görülürler. Diğer lezyonlarla sıklıkla karıştırılan bir hastalıktır. Çalışmamızda, sağ üst kadranda ağrı ve öne eğilmeyle artan nefes darlığı, göğüs ağrısı şikâyetiyle kliniğimize müracaat eden, bilgisayarlı toraks tomografisi ve magnetik rezonans görüntülemede hidatik kist ile diyafragma hernisi ayrımı yapılamayan ve torakotomide perikard kisti olduğu görülen 34 yaşında kadın hastayı sunmayı amaçladık. Perikard kisti göğüs ağrısı olan hastalarda ön tanılarda unutulmaması gereken bir patolojidir.

Anahtar Kelimeler:

Perikard Kisti, Toraks, Bilgisayarlı Tomografi, Magnetik Rezonans

Pericardial Cyst: A Case Report

Nonneoplastic mediastnal cysts occupy approximately 20% of primer mediastinal lesions and pericardial cysts account 20-30% of mediastinal cysts. Generally these cysts have congenital origin and become symptomatic in the 4th or 5th decades. Patients with congenital pericardial cysts are usually asymptomatic and cysts are detected incidentally on radiographic examination. They are usually located in right cardiophrenic sinus and less frequently in left costaphrenic sinus, hilus and upper mediasten. . Differential diagnosis of pericardial cyst is complicated. We aimed to present 34 years old female patient that reffered to our clinic with right upper quadrant pain, dyspnea by leaning and chest pain. Patients was misdiagnosed as hydatic cyst or diaphragmatic hernie by magnetic resonance and computed tomography examination however thorcotomy revealed out pericardial cyst. Pericardial cyst should be taken into consideration in the differential diagnosis of mediastinal lesions.

Keywords:

Pericardial Cyst, Thorax, Computed Tomography, Magnetic Resonance,

PDF

___

1. Pickhardt QC. Pleurodiaphragmatic cyst. Ann Surg 99:814, 1934. 2. Lillie WI, McDonald JR, Clagett OT. Pericardial celomic cysts and pericardial diverticula. A concept of etiology and report. J Thorac Surg 1950;20(3):494-504. 3. Lambert AVS. Etiology of thin-walled thoracic cysts. J Thorac Surg 10:1, 1940. 4. Strollo DC, Rosado-de-Christenson ML, Jett JR. Primary mediastinal tumors Part II. Tumors of the Middle and Posterior Mediastinum. Chest 1997;112(5):1344-57. 5. Unverferth DV, Wooley CF. The differential diagnosis of paracardiac lesions: pericardial cysts. Cathet Cardiovasc Diagn 1979;5(1):31-40. 6. Okubo K, Chino M, Fuse J. Life-saving needle aspiration of a cardiac-compressing pericardial cyst. Am J Cardiol 2000;85(4):521. 7. Le Roux B. Pericardial coelomic cysts. Thorax 1959;14:27–34. 8. Feigin D. Pericardial cysts. A radiologic-pathologic correlation and review. Radiology 1977;125(1):15–20. 9. Brown K, Aberle DR, Batra P, Steckel RJ. Current use of imaging in the evaluation of primary mediastinal masses. Chest 1990;98(2):466–73. 10. McLeod A, Dewhurst N. An unusual cause of chest pain. Scott Med J 2002;47(1):38–9. 11. Okubo K, Chino M, Fuse J, et al. Life-saving needle aspiration of a cardiac-compressing pericardial cyst. Am J Cardiol 2000;85(4):521. 12. Satur C, Hsin M, Dussek J. Giant pericardial cysts. Ann Thorac Sung 1996;61(1):208–10. 13. Borges AC, Gellert K, Dietel M. Acute right-sided heart failure due to hemorrhage into a pericardial cyst. Ann Thorac Surg 1997;63(3):845-847. 14. Klatte EC, Yüne HY. Diagnosis and treatment of pericardial cysts. Radiology 1972; 104(3):541-544. 15. Chopra PS, Duke DJ, Pellett JR, Rahko PS. Pericardial cyst with partial erosion of the right ventricular wall. Ann Thorac Surg 1991;51(5):840-842. 16. Vinee P, Stover B, Sigmund G. MR imaging of the pericardial cyst. J Magn Reson Imaging 1992;2(5):593- 596.