Branchial Cyst

Branchial Cyst

Q. 1

True about branchial cyst

 A

Wall consists of lymphoid tissue

 B

Seen deep to lower 1/3 of sternocleidomastoid

 C

Filled with straw coloured fluid with cholesterol crystals

 D

b and c

Q. 1

True about branchial cyst

 A

Wall consists of lymphoid tissue

 B

Seen deep to lower 1/3 of sternocleidomastoid

 C

Filled with straw coloured fluid with cholesterol crystals

 D

b and c

Ans. D

Explanation:

Ans. is ‘b’ i.e. Wall consists of lymphoid tissue and ‘c’ ie. Filed with straw coloured fluid with cholesterol crystals

“A branchial cyst probably develops from the vestigial remnants of the second branchial cleft, is usually lined by squamous epithelium and contains thick, turbid fluid, full of cholesterol crystals… Microscopic examination of these cysts commonly shows a layer of lymphoid tissue and the modern theory is that these cysts may arise as a result of branchial epithelium entrapped within a lymph node.” – Bailey


Q. 2

Commonest treatment of Branchial cyst-

 A

Cystectom y

 B

Aspiration

 C

Excision

 D

Nothing done

Q. 2

Commonest treatment of Branchial cyst-

 A

Cystectom y

 B

Aspiration

 C

Excision

 D

Nothing done

Ans. C

Explanation:

Ans. is ‘c’ i.e., Excision


Q. 3

Which of the following statements about Branchial cysts is true:

 A

50-70% are seen in lungs

 B

Most common site is mediastinum

 C

They are premalignant lesions

 D

Infection is uncommon in Pulmonary bronchogenic cysts

Q. 3

Which of the following statements about Branchial cysts is true:

 A

50-70% are seen in lungs

 B

Most common site is mediastinum

 C

They are premalignant lesions

 D

Infection is uncommon in Pulmonary bronchogenic cysts

Ans. B

Explanation:

Answer is B (Most common site is mediastinum):

Most common site of bronchial/bronchogenic cysts is mediastinum. Only about 15% of bronchogenic cysts occur in the lungs (pulmonary bronchial cysts). Pulmonary bronchogenic cysts often become infected. Bronchogenic cysts are benign lesion and do not have malignant potential (not premalignant).

Bronchial Cyst/Bronchogenic cysts: Review

  • Bronchial cysts represent islands of bronchial tissue left behind during the branching of the airways during early fetal development.
  • They arise due to abnormal budding of the tracheobronchial tree and foregut and are lined by bronchial epithelium.
  • The most common site of bronchial cysts is mediastinum.
  • The other site of bronchial cyst is within the pulmonary parenchyma (lung) (Less common site – 15%)

  Mediastinal bronchial cyst                                                       Pulmonary parenchymal cyst (lungs)

  • Most common site for bronchial cysts
  • Most common site is middle mediastinum
  • Commonly arise when bronchial tissue is
  • separated from airways early in gestation
  • Communication with tracheobronchial tree is rare
  • Less common site (- 15%)
  • Most common site is the lower lobes
  • Commonly arise when bronchial tissue is separated from airways late in gestation
  • Communication with tracheobronchial tree is more common than with mediastinal cysts.
  • These cysts often become infected.

 

  • Most bronchogenic cysts are asymptomatic and discovered as incidental radiographic findings in a young adult.
  • When symptoms do occur they result most commonly from infection.

Pulmonary parenchymal cysts often become infected – Rudolph

  • Bronchogenic cysts are not considered premalignant lesions. However according to Rudolph’s textbook there is a small risk of malignant change and the best approach is removal and histological examination.

Quiz In Between


Q. 4

Commonest site of branchial cyst:       

September 2012

 A

Lower 1/3rd of sternomastoid on anterior border

 B

Lower 1/3rd of sternomastoid on posterior border

 C

Upper 1/3rd of sternomastoid on anterior border

 D

Upper 1/3rd of sternomastoid on posterior border

Q. 4

Commonest site of branchial cyst:       

September 2012

 A

Lower 1/3rd of sternomastoid on anterior border

 B

Lower 1/3rd of sternomastoid on posterior border

 C

Upper 1/3rd of sternomastoid on anterior border

 D

Upper 1/3rd of sternomastoid on posterior border

Ans. C

Explanation:

Ans. C i.e. Upper 1/3rd of sternomastoid on anterior border

Branchial cyst

  • MC site: Upper part of neck,
  • Wall is made of: Lymphoid tissue

Q. 5

True about Branchial cyst is:       

March 2013 (h)

 A

Cysts are more common than sinuses

 B

Mostly arises from 2nd branchial system

 C

Causes dysphagia and hoarseness

 D

Sinus should always be operated

Q. 5

True about Branchial cyst is:       

March 2013 (h)

 A

Cysts are more common than sinuses

 B

Mostly arises from 2nd branchial system

 C

Causes dysphagia and hoarseness

 D

Sinus should always be operated

Ans. B

Explanation:

Ans. B i.e. Mostly arises from 2nd branchial system


Q. 6

Branchial cyst arises from the which branchial cleft:

September 2009

 A

First

 B

Second

 C

Third

 D

Forth

Q. 6

Branchial cyst arises from the which branchial cleft:

September 2009

 A

First

 B

Second

 C

Third

 D

Forth

Ans. B

Explanation:

Ans. B: Second

Branchial cleft cysts are congenital cysts, that arise in the lateral aspect of the neck when the second branchial cleft fails to close during embryonic development.

At about the fourth week of embryonic life, 4 branchial (or pharyngeal) clefts develop between 5 ridges known as the branchial (or pharyngeal) arches. These arches and clefts contribute to the formation of various structures of the head and neck.

The second arch grows downwards and ultimately covers the third and fourth arches. The buried clefts normally disappear around the seventh week of development. If a portion of the cleft remains entrapped and fails to disappear, its remnants form a cyst.

Branchial cleft cysts are the most common of congenital neck masses.

They are bilateral in about 2-3% of the cases. Usually, they do not appear at birth, but become noticeable much later in life. They are usually lined by squamous epithelium, and contains thick, turbid fluid full of cholesterol crystals.

They are usually located at the junction of the upper third and middle third of the sternomastoid muscle at its anterior border.

It is a fluctuant swelling that may transilluminate.

If they get infected, they may form a deep neck abscess or a draining fistula.

USG and fine-needle aspiration both aids diagnosis.

The treatment of branchial cleft cysts is surgical excision.


Q. 7

The most common site of the branchial cyst is:

 A

Posterior border of sternocleidomastoid

 B

Anterior border of sternocleidomastoid

 C

Digastric muscle

 D

Omohyoid muscle

Q. 7

The most common site of the branchial cyst is:

 A

Posterior border of sternocleidomastoid

 B

Anterior border of sternocleidomastoid

 C

Digastric muscle

 D

Omohyoid muscle

Ans. B

Explanation:

Answer. B. Anterior border of sternocleidomastoid

  • A branchial cleft cyst (BCC) commonly presents as a solitary, painless mass in the neck of a child or young adult.
  • They are most commonly located along the anterior border and the upper third of the sternocleidomastoid muscle in the anterior triangle of the neck.

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Quiz In Between



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