Case Report

High-riding Superior Pericardial Recess: Temporal Change Can Help Distinguish From Mediastinal Pathology

Authors: Manohar Aribandi, MD


A high-riding superior pericardial recess is an infrequently encountered normal variant which may mimic mediastinal pathology. We present a patient in whom a high-riding superior pericardial recess could confidently be diagnosed on a neck CT due to its change in size and shape demonstrated on a chest CT which was done 4 minutes later.

Key Points

* The superior pericardial recess, called the high-riding superior pericardial recess, is the posterior portion of the superior aortic recess and may sometimes extend more superiorly than normal.

* The high-riding superior pericardial recess may mimic a cystic mediastinal mass or an enlarged mediastinal lymph node.

* Change in configuration of this structure between two scans, as demonstrated in this patient, could be helpful in making the correct diagnosis and avoiding a false interpretation.

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