Caceres’ Corner Case 185 (Update: Solution!)


Dear Friends,

Today’s radiographs belong to a 68-year-old man in whom a chest abnormality was found in a routine check-up.
Check the images below, leave your thoughts in the comments section, and come back for the answer on Friday.

Diagnosis:

  1. Pericardial cyst
  2. Thymoma
  3. Hydatic cyst
  4. None of the above

Click here for the answer

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28
May 2018
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DISCUSSION 18 Comments

18 Responses to : Caceres’ Corner Case 185 (Update: Solution!)

  1. MK says:

    Hello!!

    There is an increased round density next to right mediastinum (sillhoute sign) with calcified margins… pericardical cyst?

    I think there is another nodular lesion lateral to the paraspinal line…

  2. MaríaP says:

    The interrumption of the horizontal fissure at lateral view, makes me think about a pulmonary origin of the oppacity, but… it has obtuse angles with the mediastinum so it should be mediastinal.
    There may be some deformation of the cardiopericardical silhouette, w/ calcificacion. ¿Auricular pseudoaneurysm?

  3. Trinity says:

    Good afternoon sir. The right cardiac border shows increased opacity with convex lateral smooth margins. The lateral view shows a curvilinear calcific opacity on its superior aspect. The RPA is seen coursing through the opacity with no vascular abnormality. On lateral view the opacity is seen to lie in the region of the cardiac chambers.
    Likely differential is
    1.right atrial aneurysm with calcification.
    2.pericardial cyst.
    3. Anterior mediastinal mass of cystic nature.

    Regards

  4. Marco S says:

    The appearance of the calcifications suggests the presence of multiple layers in the PA projection. On the lateral projection there is a clear calcific “shell” and smaller rounded opacities anterior to the main one. I think this could be an Hydatid cyst.

    • Trinity says:

      Hydatid cysts of lung do not calcify

      • Jose Caceres says:

        I agree with you about hydatid cyst of the lung not calcifying. The appearance of the lesion suggests a mediastinal mass and hydatid cyst of mediastinum may calcify

  5. Odai HASSAN says:

    Rt atrial dilatation

  6. Muhammad Ayub says:

    Cystic mass showing calcification most probably hydrated cyst

  7. Adel says:

    The lateral view the lesion in anterior aspect,with crescent of calcification ..c.t scan examination is needed
    But primarily I may say thymoma or pericardial cyst.

  8. Luis Enrique Riascos Vallecilla says:

    Pericardial cyst

  9. Josias David Pirela Castillo says:

    Lads calcificaciones perifericas a una lesión de baja densidad son frecuentemente observadas en quistes. Muy probablemente se trata de un quiste pericardico.

  10. Ren says:

    here is an round mass next to right mediastinal border sillhouting it with obtuse angles with medication. Peripheral rim calcification… pericardical cyst.hydatid cyst.

  11. Adan Bello Baez says:

    Auricular pseudoaneurism.

  12. BigDee says:

    Pavm

  13. nistor cotelea says:

    I think this hydatid cyst.

  14. Staleks says:

    I think it can be pericardial cyst, because patient is not so young for the thymoma )

  15. Sb says:

    İ think it could be thymoma
    Well defined round mass with calcifications
    And on the lateral view it is at The anterior mediastinum

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