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Case No. 312
2013-08-01~2013-08-31
출제자 : 황승배
Hit : 424
| Period | 2013-08-01~2013-08-31 |
|---|---|
| Diagnosis | Cervical thymic cyst |
| Clinical information | 18/F C/C : Soft, non-tender, palpable mass in the lower anterior neck 진단은? |
| Discussion | Cervical thymic cyst 18/F C/C : Soft, non-tender, palpable mass in the lower anterior neck 영상소견 : Left lower anterior neck에 약 2.5 x 4cm 크기의 well-defined, unilocular cystic mass가 있음. 종괴는 left lateral visceral space에 위치하며 carotid space의 내측에 위치하고 있고 carotid artery를 lateral displacement시키고 있음. 종괴는 left thyroid gland의 inferior pole과 abutting되어 있으나 thyroid gland를 밀고있는 양상이고 종괴와 thyroid gland사이에 fat plane이 유지되어 보여 extrathyroidal origin으로 판단됨. 종괴는 excision하여 thymic cyst로 확진되었음. Cervical thymic cyst Cystic remnants of thymopharyngeal duct or thymic rests - Thymus : arise from 3rd & 4th pharyngeal pouches - Embryologic migration follows a caudal course along thymopharyngeal duct Best diagnostic clue - Cystic mass in lateral infrahyoid neck, in lateral visceral space or adjacent to carotid space Closely associated with carotid sheath Uni- or multilocular, non-enhancing cystic lesion Anywhere along thymopharyngeal duct from pyriform sinus to anterior mediastinum Usually lateral left infrahyoid neck at level of thyroid gland May splay carotid artery and jugular vein Cyst wall or solid nodules may enhance slightlyl - Aberrant thymic tissue - Lymphoid aggregates - Parathyroid tissue D/Dx 1) 2nd branchial cleft cyst 2) 4th brachial anomaly 3) Lymphatic malformation 4) Abscess 5) Thyroid cyst Reference Harnsberger. Diagnostic imaging, Head and neck, second edition |
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