Branchial cleft cyst.A developmental alteration of the branchial clefts or pouches can result in cysts, sinuses, and/or fistulas. A branchial cleft cyst branchial cleft cyst Branchial cyst A cyst-like embryologic rest–remnant present at birth, which arises from branchial clefts, usually the 2nd is a congenital abnormality usually located in the lateral neck along the anterior portion of the sternocleidomastoid muscle Noun 1. sternocleidomastoid muscle - one of two thick muscles running from the sternum and clavicle to the mastoid and occipital bone; turns head obliquely to the opposite side; when acting together they flex the neck and extend the head ; it can also involve the ear and parotid parotid /pa·rot·id/ (pah-rot´id) near the ear. pa·rot·id adj. 1. Situated near the ear. 2. Of or relating to a parotid gland. n. A parotid gland. salivary gland. There is no sex preference, and although the lesion usually presents clinically in young patients, older patients are occasionally affected as well. The cysts are typically nontender masses that may become secondarily inflamed or infected, which often brings them to clinical attention. Bilateral masses are associated with an increased likelihood of a syndrome. A branchial cleft cyst is made up of a dense lymphoid infiltrate that is intimately associated with an epithelium-lined cyst or cysts (figure 1). There is ordinarily no separation between the lymphoid component and the epithelium. The cystic spaces are usually lined with squamous epithelium with keratinaceous debris filling the lumen, but respiratorytype epithelium can also be seen (figure 2). Germinal center formation is commonly seen in the lymphoid component, but a true lymph node architecture with sinus formation, a medullary medullary /med·ul·lary/ (med´ah-lar?e) 1. pertaining to a medulla. 2. pertaining to bone marrow. 3. pertaining to the spinal cord. region, or interfollicular zones is absent. With repeated cycles of infection and/or inflammation and resolution, fibrosis and granulation tissue with histiocytic histiocytic pertaining to histiocytes. histiocytic leukemia see malignant histiocytosis. histiocytic lymphocyte prolymphocyte. debris will be all that remains of the cyst. The diagnosis is usually easy, but occasionally a very well-differentiated metastatic cystic squamous cell carcinoma squamous cell carcinoma n. A carcinoma that arises from squamous epithelium and is the most common form of skin cancer. Also called cancroid, epidermoid carcinoma. from the tonsil tonsil Small mass of lymphoid tissue in the wall of the pharynx. The term usually refers to the palatine tonsils on each side of the oropharynx. They are thought to produce antibodies to help prevent respiratory and digestive tract infection but often become infected can cause confusion. A lymphangioma may have lymphocytes but does not have an epithelial lining. [FIGURES 1-2 OMITTED] Surgical excision is the treatment of choice. It is best performed when the lesion is not infected or acutely inflamed. Suggested reading Verbin RS, Barnes L. Cysts and cyst-like lesions of the oral cavity, jaws and neck In: Barnes L, ed. Surgical Pathology of the Head and Neck. 2nd ed, vol. 3. New York: Marcel Dekker, 2001:1486-98. Thompson LD, Heffner DK. The clinical importance of cystic squamous cell carcinomas in the neck: A study of 136 cases. Cancer 1998;82: 944-56. From the Department of Pathology, Woodland Hills Medical Center, Southern California Permanente Medical Group, Woodland Hills, Calif. |
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