A bursal-like space within the pericardial fat pad at the cardiac apex, where the fat pad cushions the pericardium against the chest wall. Enlargement of this space is visible on imaging as a cardiophrenic angle mass.
The pericardial fat pad bursa space is the site of pericardial fat pad herniation through congenital pericardial defects, producing a cardiophrenic angle mass on chest X-ray mimicking a tumour. CT identifies the fat attenuation of the herniating fat pad. Pericardial cysts develop in adjacent pericardial tissue and may be indistinguishable from enlarged pericardial fat on plain X-ray.
Fat herniation through a congenital pericardial defect producing a cardiophrenic angle mass on chest X-ray with fat attenuation on CT, managed conservatively once confirmed benign.
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