Pericardial sleeve recess

Case contributed by Luke Danaher
Diagnosis certain


Chest pain

Patient Data

Age: 60 years
Gender: Male



A focal density surrounds the right inferior pulmonary vein (RIPV). The structure is continuous with the posterior and inferior pericardial recesses on coronal and sagittal series respectively. Attenuation value of 9 HU. "Sling-like" morphology. It mimics an enlarged lymph node.

Case Discussion

Pericardial recesses can mimic mediastinal lymph node enlargement.

This is common superiorly along the origins of the great vessels.

An understanding of the pericardial recess anatomy is important in distinguishing this normal variation from enlarged lymph nodes or soft tissue masses in the mediastinum.

Viewing these structures in 3-plane thin-section imaging as well as density measurements can help identify these normal structures.

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