case_images: PMC6051322_01
case_images: (a) Chest X-ray immediately following pacemaker insertion procedure showing normal right atrial contour with no opacification in the right lung field. (b) Chest X-ray showing opacity in the right middle lobe on admission. (c) Computed tomography showed a thickened pericardium and pericardial effusion (blue arrow), pericardial cyst (blue stars), and the pacemaker electrode lining the epicardial surface of the right ventricle (yellow arrow).
case_images: CRIC2018-2527413.001.jpg
case_images: PMC6051322_01_CRIC2018-2527413.001.jpg
case_images: fig1
case_images: Chest film showed a round opacity with smooth borders in the midright lung field:a major change compared to prior films (Figures 1(a) and 1(b)). C-reactive protein (CRP) of 6.25 mg/dL. Computed tomography (CT) of the chest revealed thickened pericardium with pericardial effusion (Figure 1(c), blue arrow), a 6.8 x 6.2 cm thick-walled pericardial cystic mass (blue stars) adjacent to the tip of atrial pacemaker lead suspected to be extracardiac (yellow arrow).
case_images: Intraoperative images during resection of the pericardial surgery and the resected pericardial cyst.
case_images: CRIC2018-2527413.002.jpg
case_images: PMC6051322_01_CRIC2018-2527413.002.jpg
case_images: fig2
case_images: Macroscopically, the cyst wall was thickened with intense fibrosis, areas of hemorrhages, and active inflammation (Figure 2).
case_images: Microscopic description of the inflamed pericardial pseudocyst. (a) The inner cyst wall was devoid of the epithelial lining with ulceration and hemorrhage (blue arrows) on a background of chronic inflammation (yellow stars). (b) The outer cyst surface showed fibrinous exudate (yellow arrows).
case_images: CRIC2018-2527413.003.jpg
case_images: PMC6051322_01_CRIC2018-2527413.003.jpg
case_images: fig3
case_images: Histological examination revealed a lack of the epithelial lining over the inner surface, scattered ulcerations, fibrin depositions, hemorrhages, hemosiderin-laden macrophages, and chronic inflammation (Figure 3).