PURPOSE: The purpose of this study was to evaluate the CT features of second branchial cleft cysts. MATERIALS AND METHODS: We retrospectively analyzed the computed tomographic images in nine cases of second branchial cleft cyst which was confirmed pathologically. Emphasis was on localization of the masses to fascial spaces as defined by the deep cervical fasica. RESULTS: In all nine cases, the lerions were located in the submandibular and carotid spaces. Among these cases, six(67%) had simultaneous involvement of the other contiguous spaces, such as anterior and posterior cervical spaces. All cases had round or oval, unilocular, cystic masses with partial or complete rim enhancement. In eight cases(89%), smooth and thin walls were observed. In one case, thick wall and septations were noted. No definite calcifications were noted in all cases. The internal contents of cystic masses showed relatively homogeneous appearance, and CT number ranged from 20 to 35.2 Hounsfield unit(HU)(mean, 28.4HU). CONCLUSION: CT diagnosis of second branchial cleft cyst would be easily obtained from recognition of frequent simultaneous involvement of the other contiguous spaces, along with a typical location and characteristic morphology.
Branchial Region* ; Branchioma* ; Diagnosis ; Retrospective Studies

Branchial Region ; Branchioma/diagnosis* ; Humans ; Sleep ; Snoring

Though branchial cleft cysts (BCC) are common cause of congenital cyst formation in the neck, the prenatal cases have been reported very rarely. We discovered fetal neck cyst at 32 weeks of gestation and eventually diagnosed it as BCC by postnatal surgical excision and histologic findings. It is hard to establish differential diagnosis of BCC from other congenital neck cysts on fetal ultrasonography. The anatomic locations and clinical features of each cystic lesions are important to diagnose accurately and then to achieve complete surgical excision for recurrence-free treatment. We present a case of a BCC detected prenatally and survey the points of differential diagnosis of a BCC from other neck cystic lesions on fetal ultrasonography.
Branchial Region ; Branchioma ; Diagnosis, Differential ; Neck ; Pregnancy ; Ultrasonography, Prenatal

Cervical branchial cleft cysts are uncommon lesion that are developed from remnants of branchial apparatus in embryonal period. These cysts are found in infancy, childhood and adult by recurrent symptoms related to inflammation. It is difficult to find these cysts with antenatal ultrasonography and differential diagnosis from other cervical cysts is difficult too. We experienced a case of fetal cervical branchial cleft cyst that was found with antenatal ultrasonography and diagnosed with surgical biopsy, so we report our case with brief review of literatures.
Adult ; Biopsy ; Branchial Region ; Branchioma ; Diagnosis, Differential ; Fetus ; Humans ; Inflammation

The hypothesis that primary branchiogenic carcinoma originates from a branchial cleft cyst is controversial since the entity was first described in 1882. In 1950, stringent criteria were established for the diagnosis of primary branchiogenic carcinoma, the most important criterion being histologic proof of carcinoma arising from a normal cyst epithelium. Only a limited number of cases have successfully fulfilled these criteria. In this article, we describe a case of squamous cell carcinoma arising in the second branchial cleft cyst and also discuss the diagnosis, histopathologic features, and therapeutic options.
Branchial Region* ; Branchioma* ; Carcinoma, Squamous Cell ; Diagnosis ; Epithelium

Branchioma ; diagnosis ; Head and Neck Neoplasms ; diagnosis ; Humans ; Neck ; Rheumatoid Nodule ; diagnosis

BACKGROUND AND OBJECTIVES: The branchial anomaly is a lateral neck mass commonly seen by otolaryngologists. Although somewhat controversial, almost all surgeons agree that lateral cervical cyst, fistula and sinus are of branchogenic origin. Depending on its anatomic location, branchial anomaly can be classified into first, second, third and fourth. The purpose of this study is to evaluate the clinical and pathologic manifestations of branchial anomaly and to determine proper diagnosis and treatment. MATERIALS AND METHOD: With a review of charts, we retrospectively analyzed 46 cases of the branchial anomaly who had been treated at the Hanyang University Medical Center between 1991 and 2001. Age, sex, site of lesion, classification, surgical therapy, radiologic and pathologic findings and post-operative surgical complications were reviewed. RESULTS: The second branchial cyst was the most common anomaly. Patients were commonly seen in the 3rd and 4th decades. Compared with cysts, the fistulas and sinuses were detected relatively at the younger age. Twenty five per cent of patients were presented in the infected state, and 45 cases were treated with complete surgical excision; there were no major post-operative complications and recurrence. CONCLUSION: An accurate diagnosis is crucial in the management of branchial anomaly to prevent recurrence and multiple surgical procedures. Although clinical examination and history are the most important factors suggesting the diagnosis of branchial anomaly, preoperative radiologic evaluation can be used to determine the nature and extent of the branchial anomaly. After control of acute inflammation or abscess, the complete surgical excision is crucial for a successful outcome.
Abscess ; Academic Medical Centers ; Branchial Region ; Branchioma ; Classification ; Diagnosis ; Fistula ; Humans ; Inflammation ; Neck ; Recurrence ; Retrospective Studies

Phlebectasia is an abnormal dilatation of an isolated vein and a rare venous anomaly and is usually asymptomatic. Internal jugular phlebectasia is a localized, nonpulsatile, nontender, compressible, and saccular or fusiform dilatation that enlarges with Valsalva maneuver, sneezing, coughing and straining which increases intrathoracic pressure. Internal jugular phlebectasia predominantly affects young children and its etiology is idiopathic in most cases, but several predisposing factors have been suggested. Although histopathological findings of most cases had no significant abnormality, those of some cases showed elastic dysplasia, focal intimal thickening and muscular defect within the wall of the vein. A swelling in the neck which enlarges with Valsalva maneuver must be differentiated from other diseases. Internal jugular phlebectasia is most likely to be mistaken for laryngocele, superior mediastinal cyst or branchial cleft cyst. Diagnosis should be as non-invasive as possible because no treatment is indicated for this benign self-limiting condition. We present a case of bilateral internal jugular phlebectasia of which diagnosis was made by sonography with doppler technique and neck CT.
Branchioma ; Causality ; Child ; Cough ; Diagnosis ; Dilatation ; Humans ; Laryngocele ; Mediastinal Cyst ; Neck ; Sneezing ; Valsalva Maneuver ; Veins

A trichilemmal cyst is a skin adnexal tumor that usually occurs on the scalps of elderly women. We report a trichilemmal cyst in the submandibular area of a 16-year-old male, masquerading as a second branchial cleft cyst. During surgery, the mass was found to have invaded the submandibular gland and needed to be excised totally in continuity with the submandibular gland. To our knowledge, this is the first reported case of a trichilemmal cyst involving the submandibular gland. Although rare, a trichilemmal cyst may be considered in the differential diagnosis of cystic lesions in the submandibular area. It should also be differentiated from other cystic malignant tumors for its tendency to invade the surrounding structure.
Adolescent ; Aged ; Branchioma ; Diagnosis, Differential ; Female ; Humans ; Male ; Scalp ; Skin ; Submandibular Gland*

PURPOSE: Cervical masses are frequently occurred in children. They are most often associated with nonspecific infection. However, they may be presented as congenital abnormalities. Therefore, accurate history taking, physical examination and appropriate diagnostic procedure are absolutely required for the differential diagnosis of neck mass in children. METHODS: To elucidate the clinical characteristics of cervical mass which may help for establishing a correct diagnosis, the clinical records including pathologic findings from the biopsied specimen of twenty-eight children under seventeen years of age who were hospitalized with complain of persistently palpable neck mass were completely reviewed. RESULTS: Pathologic classification of the cervical mass was as follows : 15(53.6%) thyroglossal duct cyst, 7(25.0%) branchial cleft cyst, 5(17.9%) cystic hygroma and 1(3.6%) bronchogenic cyst. Asymptomatic mass was the most common presentation(67.8%). Twenty-six (92.8%) lesions were solitary and 2(7.1%) branchial cleft cyst were multiple. All thyroglossal duct cyst presented as a solitary mass and involved the midline of the neck. Branchial cleft cysts were located around sternocleidomastoid muscle, and multiple branchial cleft cyst located bilaterally in submandibular area. CONCLUSIONS: The accurate medical history, physical examination, and additional pathologic findings are the most important for the diagnosis of congenital neck mass in children.
Biopsy ; Branchioma ; Bronchogenic Cyst ; Child* ; Classification ; Congenital Abnormalities ; Diagnosis ; Diagnosis, Differential* ; Humans ; Infant* ; Lymphangioma, Cystic ; Neck ; Physical Examination ; Thyroglossal Cyst