Natali F, Kermarec J, Allard P, Herning R, de Muizon H, Hocquel J
Poumon Coeur. 1982;38(6):359-62.
Radiological examination in a young adult revealed the presence of an opacity facing the second left arch of the heart shadow. This finding associated with data from computed tomography suggested a diagnosis of a thymic tumor. Surgical exploration demonstrated a defect in the left pericardium through which there was a rhythmic protrusion of the auricle and fatty tissue. Aplasia of the pericardium is rarely observed, and usually involves its left side. It results from premature atrophy of the left Cuvier's canal, and is associated with cardiac or pulmonary anomalies in half of the cases. Diagnosis should be suggested by the abnormal appearance of the second left arch, very often clinically asymptomatic, and is confirmed when the creation of a pneumothorax produces a simultaneous pneumopericardium. A thoracic scan can visualize the left auricular hernia beyond the mediastinal limits. However, pericardial aplasia must remain a differential diagnosis of pathological opacities in the middle mediastinum.
一名年轻成年人的放射学检查显示，心脏阴影左第二弓处存在不透明区。这一发现与计算机断层扫描数据相结合，提示诊断为胸腺肿瘤。手术探查发现左心包有缺损，心房和脂肪组织有节律地由此突出。心包发育不全很少见，通常累及左侧。它是由左居维叶管过早萎缩引起的，半数病例伴有心脏或肺部异常。诊断应根据左第二弓的异常表现提出，这种表现通常在临床上无症状，当气胸导致同时出现心包积气时可确诊。胸部扫描可以显示超出纵隔范围的左心房疝。然而，心包发育不全必须始终作为中纵隔病理性不透明的鉴别诊断。
