Cervical Thymic Cyst with parathyroid tissue – a diagnostic conundrum
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| Format: | Artículo científico |
| Language: | en |
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Hospital Universitário da Universidade de São Paulo
2022
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| author | Deepika Gupta |
| author_facet | Deepika Gupta |
| contents | Cervical Thymic Cyst with parathyroid tissue – a diagnostic conundrum Deepika Gupta Darwin Kaushal Deepak Vedant Rashim Sharma Vikarn Vishwajeet Poonam Abhay Elhence Medicina Cysts Surgical Pathology Branchioma Child Development Cervical thymic cysts are relatively rare benign cystic lesions that tend to be diagnosed clinically as branchial cysts, which usually present as painless, enlarging neck masses. They can occur anywhere along the normal path of descent of thymic primordia from the angle of the mandible to the sternal notch, with mediastinal extension observed in approximately 50% of cases. They are usually seen in the first decade of life on the left side with a male predominance. Here we report a case of a 15-year-old boy who presented to the hospital with left-sided neck swelling for about 2 months. The neck’s contrast-enhanced computed tomography (CECT) revealed a large, well-defined cystic swelling in the left neck region, showing peripheral enhancement, seen from the submandibular region to the superior mediastinum extending into the retrosternal region. Direct fine needle aspiration (FNA) was done, which showed a benign lesion with inflammatory and cystic characteristics, leading to the possibility of a branchial cyst. The cyst was completely excised surgically. Histopathology showed a thymic cyst with parathyroid tissue. The presence of thymic tissue with Hassall’s corpuscles is essential for the diagnosis. Knowledge of the clinical presentation, cyto-histological findings, and differential diagnosis of cystic cervical lesions in the pediatric population is important to diagnose this rare entity. Hence, though uncommon, when one comes across a cystic cervical region mass in children, a diagnosis of cervical thymic cyst should be kept in mind. Nonetheless, a definitive diagnosis depends on imaging findings as well as intraoperative findings and histopathological examination. 2022 otro 2236-1960 https://www.redalyc.org/articulo.oa?id=576069818014 https://www.redalyc.org/journal/5760/576069818014/ https://www.redalyc.org/journal/5760/576069818014/html/ https://www.redalyc.org/journal/5760/576069818014/576069818014.epub https://www.redalyc.org/journal/5760/576069818014/movil 10.4322/acr.2021.361 en http://www.redalyc.org/revista.oa?id=5760 Autopsy and Case Reports application/pdf Hospital Universitário da Universidade de São Paulo Autopsy and Case Reports (Brasil) Vol.12 |
| format | Artículo científico |
| id | redalyc_576069818014 |
| institution | Redalyc |
| language | en |
| publishDate | 2022 |
| publisher | Hospital Universitário da Universidade de São Paulo |
| spellingShingle | Cervical Thymic Cyst with parathyroid tissue – a diagnostic conundrum Deepika Gupta Medicina Cysts Surgical Pathology Branchioma Child Development Cervical Thymic Cyst with parathyroid tissue – a diagnostic conundrum Deepika Gupta Darwin Kaushal Deepak Vedant Rashim Sharma Vikarn Vishwajeet Poonam Abhay Elhence Medicina Cysts Surgical Pathology Branchioma Child Development Cervical thymic cysts are relatively rare benign cystic lesions that tend to be diagnosed clinically as branchial cysts, which usually present as painless, enlarging neck masses. They can occur anywhere along the normal path of descent of thymic primordia from the angle of the mandible to the sternal notch, with mediastinal extension observed in approximately 50% of cases. They are usually seen in the first decade of life on the left side with a male predominance. Here we report a case of a 15-year-old boy who presented to the hospital with left-sided neck swelling for about 2 months. The neck’s contrast-enhanced computed tomography (CECT) revealed a large, well-defined cystic swelling in the left neck region, showing peripheral enhancement, seen from the submandibular region to the superior mediastinum extending into the retrosternal region. Direct fine needle aspiration (FNA) was done, which showed a benign lesion with inflammatory and cystic characteristics, leading to the possibility of a branchial cyst. The cyst was completely excised surgically. Histopathology showed a thymic cyst with parathyroid tissue. The presence of thymic tissue with Hassall’s corpuscles is essential for the diagnosis. Knowledge of the clinical presentation, cyto-histological findings, and differential diagnosis of cystic cervical lesions in the pediatric population is important to diagnose this rare entity. Hence, though uncommon, when one comes across a cystic cervical region mass in children, a diagnosis of cervical thymic cyst should be kept in mind. Nonetheless, a definitive diagnosis depends on imaging findings as well as intraoperative findings and histopathological examination. 2022 otro 2236-1960 https://www.redalyc.org/articulo.oa?id=576069818014 https://www.redalyc.org/journal/5760/576069818014/ https://www.redalyc.org/journal/5760/576069818014/html/ https://www.redalyc.org/journal/5760/576069818014/576069818014.epub https://www.redalyc.org/journal/5760/576069818014/movil 10.4322/acr.2021.361 en http://www.redalyc.org/revista.oa?id=5760 Autopsy and Case Reports application/pdf Hospital Universitário da Universidade de São Paulo Autopsy and Case Reports (Brasil) Vol.12 |
| title | Cervical Thymic Cyst with parathyroid tissue – a diagnostic conundrum |
| topic | Medicina Cysts Surgical Pathology Branchioma Child Development |
| url | https://www.redalyc.org/articulo.oa?id=576069818014 https://www.redalyc.org/journal/5760/576069818014/ https://www.redalyc.org/journal/5760/576069818014/html/ https://www.redalyc.org/journal/5760/576069818014/576069818014.epub https://www.redalyc.org/journal/5760/576069818014/movil |