Lateral Neck Mass in ultrasound (For Radiology Residents)

Complicated (Haemorrhagic) 2nd Branchial Cleft Cyst.

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___ Clinically :

It may presents in childhood as a swelling or later when complicated.

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___ Findings :-

  • A well-defined complex cyst in left lateral neck.

  • With fluid-debris level (layering means complication either hge or infection which causes rapid increase in size).

  • Located superficial to CCA, submandibular galnd and inferolateral to angle of mandile.

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___ DD :-

  • 1st branchial cleft cyst (higher location near parotid or ear).

  • Plunging ranula (if has deeper component and dumbbell shape).

  • Sternomastoid haematoma or abscess (intra-muscular and different history).

  • Lymphatic or vascular malformation (younger age, multicoluar,…).

  • LN (esp. if cystic as in suppurative nodes or pseudocystic as in lymphomatus nodes).