Branchial cleft cyst
Encyclopedia
A branchial cleft cyst is an oval, moderately movable cystic mass that develops under the skin
in the neck between the sternocleidomastoid muscle
and the pharynx
.
develop into gills.
.
. As complete surgical excision may be difficult (due to the close proximity of the internal jugular vein and carotid vessels that lie deep to the swelling), they can recur.
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
in the neck between the sternocleidomastoid muscle
Sternocleidomastoid muscle
In human anatomy, the sternocleidomastoid muscle , also known as sternomastoid and commonly abbreviated as SCM, is a paired muscle in the superficial layers of the anterior portion of the neck...
and the pharynx
Pharynx
The human pharynx is the part of the throat situated immediately posterior to the mouth and nasal cavity, and anterior to the esophagus and larynx. The human pharynx is conventionally divided into three sections: the nasopharynx , the oropharynx , and the laryngopharynx...
.
Pathology
The cyst wall will be composed of either squamous or columnar cells with lymphoid infiltrate, often with prominent germinal centers. The cyst may contain granular and keratinaceous cellular debris. Cholesterol crystals may be found in the fluid extracted from a branchial cyst.Pathophysiology
Branchial cleft cysts are remnants of embryonic development and result from a failure of obliteration of the branchial cleft, which in fishFish
Fish are a paraphyletic group of organisms that consist of all gill-bearing aquatic vertebrate animals that lack limbs with digits. Included in this definition are the living hagfish, lampreys, and cartilaginous and bony fish, as well as various extinct related groups...
develop into gills.
Types
- First branchial cleft cysts typically originate in the angle of the mandibleAngle of the mandibleAt the junction of the lower border of the ramus of the mandible with the posterior border is the angle of the mandible, which may be either inverted or everted and is marked by rough, oblique ridges on each side, for the attachment of the Masseter laterally, and the Pterygoideus internus medially;...
and extend to the external auditory canal. They are often associated with the facial nerveFacial nerveThe facial nerve is the seventh of twelve paired cranial nerves. It emerges from the brainstem between the pons and the medulla, and controls the muscles of facial expression, and functions in the conveyance of taste sensations from the anterior two-thirds of the tongue and oral cavity...
. - Second branchial cleft cysts are most common. They are found along the anterior border of the Sternocleidomastoid muscleSternocleidomastoid muscleIn human anatomy, the sternocleidomastoid muscle , also known as sternomastoid and commonly abbreviated as SCM, is a paired muscle in the superficial layers of the anterior portion of the neck...
, passes through the carotid bifurcation and into the tonsillar pillar. - Third branchial cleft cysts are rare and found in the lateral neck.
Symptoms
Most branchial cleft cysts are asymptomatic, but they may become infectedInfection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
.
Treatment
Conservative (i.e. no treatment), or surgical excisionExcision
Excision is the alias of Jeff Abel, a dubstep DJ and music boss from British Columbia, Canada. He frequently works with fellow Canadian dubstep producers Datsik and Downlink. As one of the first dubstep producers and DJs in North America, he has played a significant role in the genre's growth in...
. As complete surgical excision may be difficult (due to the close proximity of the internal jugular vein and carotid vessels that lie deep to the swelling), they can recur.
See also
- Cutaneous columnar cystCutaneous columnar cystCutaneous columnar cysts are a cutaneous condition, a group of different cysts lined by columnar epithelium. Types of cysts included in this group are:* Bronchogenic cyst* Branchial cyst* Thyroglossal duct cyst* Cutaneous ciliated cyst* Median raphe cyst...
- Cystic hygromaCystic hygromaA cystic hygroma is a congenital multiloculated lymphatic lesion that can arise anywhere, but is classically found in the left posterior triangle of the neck. This is the most common form of lymphangioma. It contains large cyst like cavities containing watery fluid.Microscopically cystic hygroma...
- RanulaRanulaMucocele is the most common lesion of the salivary glands. Mucoceles are the result of trauma. It results from either blockage or rupture of a salivary gland duct, with consequent leakage of saliva into the surrounding connective tissue stroma. Clinically, they present as a fluctuant swelling of...
- Thyroglossal duct cyst