Cystic lesions of the pericardium. Review of the literature and classification.

Pericardial cystic lesions (PCLs) occur infrequently but are significant for their varying clinical presentation and pathological multitude. A review of the literature (including Medline and Current Contents database searches, and search of existing bibliographies) finds confusion in nomenclature and an absence of appropriate classification. A new classification system is proposed based on exo- or endophytic growth, presence of adhesions, and compression of myocardium or great vessels. A multitude of pathological entities with diverse pathogenesis, disease courses, and prognoses may present as PCLs. Detailed knowledge of lesion types and alternatives among diagnostic and therapeutic options permits a selective approach to patient management. The usefulness of a unified classification system should be evaluated in a substantial patient population, with detailed statistical analysis.