Branchial cysts

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Branchial cysts and branchial sinuses are benign neck masses.

Contents

Aetiology

  • Occur in young adults
  • Occur in males 60% of the time
  • Occur on the left side 60% of the time
  • Four theories on how they develop
    • Arise from elements of squamous epithelium in a lymph node
    • Arise from remnants of the first pharyngeal pouch
    • Remnants of the cervical sinus
    • Remnants of duct between thymus and thirm pharyngeal pouch

Pathology

  • Cysts or sinuses lined by stratified squamous epithelium
  • Lymphoid tissue in walls
  • Sometimes become infected - require long term antibiotics before surgery
  • Usually arise in lymph nodes deep to the anterior border of the sternomastoid, at the junction of the upper third and lower two-thrids

Clincal assessment

  • Clincal examination
  • Fine needle aspiration
  • Role for CT or MRI if lesion is large and compressing other structures

Management

  • Surgical excision

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