Cervical Thymic Cyst Research Articles

Cervical thymic cyst

Cervical thymic cyst

Cervical thymic cyst

Cervical thymic cyst

Cervical thymic cyst

Thymic cysts are rare embryonic remnants along the course of thymic migration in the neck or the anterior mediastinum which may result in cervical masses in children, often misdiagnosed. We present the experience gained by three European tertiary care medical centers in the treatment of thymic cysts as well as the current data on the embryology, clinical presentation, diagnosis and management of thymic cysts. A retrospective study was carried out in nine patients with thymic cysts during the period 1986–2002 at the departments of Pediatric Surgery of Children’s University Hospital “Federico II” and “Santobono” Pediatric Hospital of Naples in Italy and “Aghia Sophia” Children’s Hospital of Athens in Greece. All cases were asymptomatic, appearing mainly as masses resembling branchial cyst or lymphatic malformation. Laboratory and imaging investigations were not useful for preoperative diagnosis. In one case the mass extended into the mediastinum. The histological findings of thymic tissue and Hassal’s corpuscles in the cystic wall were diagnostic. In all cases, surgery was successful and uneventful. Surgical excision was accomplished by dissection of the cystic masses from the jugular vein, carotid artery and vagus nerve and from the sternocleidomastoid muscle. The presence of a normal thymus in the mediastinum must be documented preoperatively in order to avoid the risk of total thymectomy. If a cervical thymic cyst extends into the normal thymus, attempts should be made to preserve the thymus, especially in younger patients. Thymic cysts should always be included in the differential diagnosis of lateral cervical masses, especially in children.

Cervical thymic cyst–a case record

Cystic lesions of the thymus are rare. In a large series of over 200 mediastinal cysts only 12 cases of thymic cysts have been reported (Seltzer et al., 1968). Cervical thymic cysts are so rare that only 35 cases have been documented in the English literature.

Cervical thymic cyst as a cause of acute suppurative thyroiditis

A case of acute suppurative thyroiditis following a perithyroidal abscess, which was thought to have resulted from infection of a cervical thymic cyst, is reported herein. The patient was an 8 year old asthmatic Japanese boy who originally presented with tender swelling of the left anterior neck in July, 1986. Although pharyngography could not clearly demonstrate the pyriform sinus fistula, a hypoechoic area around the left lobe of the thyroid gland was noted on ultrasonography. Incisional drainage revealed Streptococcus milleri. A diagnosis of acute suppurative thyroiditis was established, and a cystic tubular mass was surgically resected from the left perithyroidal space some time later. Histopathological examination of the specimen revealed partly cystic thymic tissue along with parathyroid tissue. These observations suggested that acute suppurative thyroiditis in this case was caused by a perithyroidal abscess and that a perithyroidal abscess may also result from infection of a cervical thymic cyst.

Lateral Cervical Thymic Cyst

Lateral Cervical Thymic Cyst

Thymic cysts of the neck

Thymic cysts of the neck are rare clinical entities. Only 45 children with cervical thymic cysts have been reported in the literature so far; 2 more cases are reported here. Both presented as cystic swellings in the left side of the neck and were pre-operatively diagnosed as a cystic hygroma and a solitary thyroid nodule. Investigations included blood counts, ultrasonograms, thyroid scans, and aspiration cytology. Both lesions could be easily excised by the cervical route. The final diagnosis was made only after histopathological examination. The relevant literature on the aetiology, pathology, clinical features, and treatment is reviewed.

Cervical thymic cysts

Four cases of cervical thymic cyst are described. Clinical and microscopic appearances are reviewed, with reference to its distinction from branchial cyst. The use of monoclonal antibodies to cytokeratin as a histologic aid to diagnosis is discussed.

Respiratory complications in cervical thymic cysts

Thymic cysts are considered uncommon lesions in the differential diagnosis of pediatric neck masses. They have been described as asymptomatic and of little clinical consequence. Recent reports have stressed the possibility of respiratory compromise associated with these lesions. We reviewed our experience with cervical thymic cysts with emphasis on respiratory problems. Ten pediatric patients underwent surgery and were found to have cervical thymic cysts. Ages ranged from newborn to 14 years. There were four boys and six girls. Two were found to have the thymic cysts at time of neck exploration for Grave's disease and hyperparathyroidism. Of the remaining eight patients, all had mobile cystic masses, located anterior to but extending beneath the lower third of the sternocleidomastoid muscle. The size of the mass ranged from 3.0 to 8.5 cm. Preoperative diagnosis included cystic hygroma/branchial cleft cyst (five), lymphoma (one), teratoma (one), and thymic cyst (one). All had a history of rapidly developing neck mass. Seven of the eight gave a history of upper respiratory tract infection (URI) prior to the development of the mass. Five had imaging studies that showed tracheal compression. Three of these required airway management in the early postoperative period. All were excised through a neck incision, with two requiring sternal extension. Histology showed cholesterol crystals, Hassall's corpuscles, and giant cell reaction diagnosis of thymic cysts. There has been no recurrence and no permanent respiratory sequela in the ten patients. Cervical thymic cysts are benign lesions that may be more common than literature suggests.(ABSTRACT TRUNCATED AT 250 WORDS)

Parenchymal cysts of the lower neck.

We report on the appearance of parathyroid, thyroid, and cervical thymic cysts on computed tomography (CT) scans. The differential diagnostic considerations include thyroglossal and branchial cleft cysts, cystic hygromas, primary and metastatic tumors, dermoids, teratomas, choristomas, tracheoesophageal and cervical bronchogenic cysts, as well as cystic neuromas, abscesses, and lipomas. Most cannot be differentiated using CT alone and require clinical observations, laboratory testing, and surgical and histologic findings for definitive diagnosis. Our experience with these rare lesions is reported, and the differential diagnoses are discussed.

けい部に発生した胸せんのうしゅの一症例

A case of cervical thymic cyst is presented, and the literature is reviewed.A 29 year-old-female was found to have a right branchial cleft cyst on CT-scan and aspiration biopsy. At operation, a cyst 2×4×2cm, below the sternocleid mastoid muscle was excised.The histological diagnosis was cervical thymic cyst.

Cervical Thymic Cyst

Various types of cysts that originate in embryonal remnants may be observed in the neck. Among these, branchial cleft and thyroglossal duct cysts are more commonly observed, whereas thymic cysts are rare. Most patients with a cervical thymic cyst complain of a painless, enlarging mass in the neck. The histopathologic features of thymic cysts are diagnostic. Cystic thymomas, which seem to have a more aggressive clinical behavior in children, should be differentiated from the benign cervical thymic cyst. Thymic cysts most probably arise from embryonic remnants of the thymopharyngeal duct. Our patient had a cervical thymic cyst with neurofibromatosis.

Cervical thymic cyst Case report

Thymic derivatives should be included in the differential diagnosis of cystic masses in the neck. A classification of thymic cysts is proposed: namely, true mixed or false. A thymic cyst may contain cholesterol crystals in the luminal fluid, cholesterol clefts, granulomas and lymphocytic follicles as well as Hassall corpuscles in the wall. Treatment consists of simple excision of the cyst and its tract. The thirty-fifth case of cervical thymic cyst in the English Literature is reported.

Progressive Neonatal Airway Obstruction Secondary to Cervical Thymic Cyst

Cervical thymic cysts are extremely unusual neoplasms that only rarely produce signs and symptoms of upper airway tract compromise. Less than 7% of patients initially have dyspnea or hoarseness. We report the first known case of progressive neonatal airway obstruction secondary to a rapidly enlarging cervical thymic cyst. Because one half of these benign tumors may demonstrate mediastinal extension, computed axial tomography or B-mode ultrasonography or both is recommended prior to surgical excision. Review of the literature confirms that the majority are successfully removed via a transcervical approach without recurrence.

Cervical thymic cysts in children

Cervical thymic cysts in children

Cervical thymic cysts in children: M. Reiner, A. R. Beck, and B. Rybak. Am J Surg 139:704–707, (May), 1980

Cervical thymic cysts in children: M. Reiner, A. R. Beck, and B. Rybak. Am J Surg 139:704–707, (May), 1980

Cervical Mediastinal Thymic Parathyroid Cyst

A case is presented to illustrate the actual location of cervical thymic cysts and to reconfirm their derivation, to review the embryology, and to identify this lesion as a possible differential diagnosis of neck cysts.

Cervical thymic cysts in children

Thymic cysts are a rare cause of cervical masses in children. The cysts usually appear between ages 6 and 7 years and present as a soft swelling in the anterior triangle of the neck. The cysts may be small and unilocular or large and multilocular; they produce few symptoms. The etiology is unclear but may be related to remnants of tissue left in the cervical region when the thymus gland descends from the neck to the mediastinum during embryologic development. Forty-three cases of cervical thymic cysts have been reported in patients under 20 years of age. Two additional cases are reported in boys 5 and 9 years of age.

Hemithyroid agenesis associated with a cervical thymic cyst

Hemithyroid agenesis associated with a cervical thymic cyst

Hemithyroid agenesis associated with a cervical thymic cyst

A case is presented of a 7-yr-old boy with left hemithyroid agenesis associated with cervical thymic cyst. No left parathyroid glands were found. The diagnosis was established after surgical excision and histologic examination. Clinical and embryological implications of this condition are briefly discussed. No similar case has been found in the literature.