Images in emergency medicine

Abstract

DiagnosisUltrasonography and CT scan demonstrated a cystic lesion consistent with the diagnosis of a second branchial cleft cyst. Branchial cleft cysts arise from vestigial remnants of the branchial apparatus from which the neck structures are formed during embryonic development. Approximately 90% of branchial cleft cysts are derived from the second branchial cleft.1Park Y.W. Evaluation of neck masses in children.Am Fam Phys. 1995; 51: 1904-1912PubMed Google Scholar Although branchial sinuses and fistulas may be apparent in infancy and early childhood, branchial cysts often go unnoticed until adulthood. These lesions typically present between the second and fourth decades of life.2Mandell D.L. Head and neck anomalies related to the branchial apparatus.Otolaryngol Clin North Am. 2000; 33: 1309-1331Abstract Full Text Full Text PDF PubMed Scopus (61) Google Scholar Patients commonly present with a painless, round, mobile, cervical mass located along the anterior border of the sternocleidomastoid muscle. Branchial cysts frequently present after an upper respiratory infection because they tend to get infected and undergo rapid expansion at that time. When infection occurs, the mass may be tender and contain purulent material. Definitive treatment for branchial cysts is complete surgical excision. Acute infections should be treated with antibiotics before excision. DiagnosisUltrasonography and CT scan demonstrated a cystic lesion consistent with the diagnosis of a second branchial cleft cyst. Branchial cleft cysts arise from vestigial remnants of the branchial apparatus from which the neck structures are formed during embryonic development. Approximately 90% of branchial cleft cysts are derived from the second branchial cleft.1Park Y.W. Evaluation of neck masses in children.Am Fam Phys. 1995; 51: 1904-1912PubMed Google Scholar Although branchial sinuses and fistulas may be apparent in infancy and early childhood, branchial cysts often go unnoticed until adulthood. These lesions typically present between the second and fourth decades of life.2Mandell D.L. Head and neck anomalies related to the branchial apparatus.Otolaryngol Clin North Am. 2000; 33: 1309-1331Abstract Full Text Full Text PDF PubMed Scopus (61) Google Scholar Patients commonly present with a painless, round, mobile, cervical mass located along the anterior border of the sternocleidomastoid muscle. Branchial cysts frequently present after an upper respiratory infection because they tend to get infected and undergo rapid expansion at that time. When infection occurs, the mass may be tender and contain purulent material. Definitive treatment for branchial cysts is complete surgical excision. Acute infections should be treated with antibiotics before excision. Ultrasonography and CT scan demonstrated a cystic lesion consistent with the diagnosis of a second branchial cleft cyst. Branchial cleft cysts arise from vestigial remnants of the branchial apparatus from which the neck structures are formed during embryonic development. Approximately 90% of branchial cleft cysts are derived from the second branchial cleft.1Park Y.W. Evaluation of neck masses in children.Am Fam Phys. 1995; 51: 1904-1912PubMed Google Scholar Although branchial sinuses and fistulas may be apparent in infancy and early childhood, branchial cysts often go unnoticed until adulthood. These lesions typically present between the second and fourth decades of life.2Mandell D.L. Head and neck anomalies related to the branchial apparatus.Otolaryngol Clin North Am. 2000; 33: 1309-1331Abstract Full Text Full Text PDF PubMed Scopus (61) Google Scholar Patients commonly present with a painless, round, mobile, cervical mass located along the anterior border of the sternocleidomastoid muscle. Branchial cysts frequently present after an upper respiratory infection because they tend to get infected and undergo rapid expansion at that time. When infection occurs, the mass may be tender and contain purulent material. Definitive treatment for branchial cysts is complete surgical excision. Acute infections should be treated with antibiotics before excision. Branchial Cleft CystAnnals of Emergency MedicineVol. 47Issue 3PreviewA 24-year-old woman presented to the emergency department with a 2-day history of increasing left-sided neck swelling (Figure 1). The patient had a history of a recent upper respiratory infection but was otherwise healthy. Vital signs, including temperature, were normal. Examination revealed a healthy-appearing white woman with a mildly tender left-sided neck mass. Further examination was performed by ultrasonography and computed tomography (CT) scan (Figures 2 and 3). Otolaryngology was consulted, and the lesion was aspirated and found to contain purulent material (Figure 4). Full-Text PDF