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Surgery Miscellaneous (Neck) a21e7077

All of the following are true about branchial cysts except -

A
They are commonly located in the posterior triangle of neck
B
They are lined by squamous epithelium
C
They are remnants of branchial apparatus that is persistent
D
It may contain granulation tissue
High-Yield Explanation
Ans. is 'A' i.e., They are commonly located in the posterior triangle of neck MASSSITEBranchial cystAnterior border of sternocleidomastoidThyroglossal cystMedian neckCystic HygromaPosterior triangleCarotid Body TumourAnterior TriangleBranchial Cleft Cystso Branchial cleft cysts are congenical cysts that are located in the lateral aspect of the neck. They are the result of developmental anomalies of the branchial clefts. Apel et al (1994) reported branchial cleft cysts located within the thyroid. The cysts may remain occult until middle or older age and may appear suddenly. The branchial cysts may become inflamed and clinically painful. The cysts are usually lined by mature squamous epithelium supported by a stroma rich in lymphoid tissue, sometimes forming mature lymph follicles. Occasionally, the squamous epitheilium is less mature and is composed of smaller squamous cells of parabasal type with large nuclei. On rare occasions, part of the cyst lining will be composed of mucus-producing columnar cellso Aspiration usually yields thick, very turbid, white or yellow fluid. The cysts may disappear after complete aspiration of the contents, resulting in cure. However, some cysts may recur and the fluid can reaccumulate. Microscopically, the fluid contains a variable number of mature squamous cells and acellular squames, proteinaceous material, cellular debris, and lymphocytes, Less often, and particularly in the presence of inflammation, the squamous cells may be smaller, of a parabasal or even basal type, and may show nuclear enlargement, some hyperchromasia, or even pyknosis. The smear background may show evidence of acute or subacure inflammation and sometimes may contain granulation tissue, characterized by numerous capillaries, fibroblasts and mono and multinucleated macrophages (Koss et al, 1992).

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