Branchial cleft cyst

Branchial cleft cyst, also branchial cleft remnant, is a benign congenital lesion of the head and neck.

General

• Benign congenital thingy in the lateral neck.
• Most common cystic neck lesion in young adults.
• Treatment: excision.

Gross

• Lateral neck mass.

Image - clinical:

• Branchial cleft cyst (thefreedictionary.com).

Microscopic

Features:

• Cystic space lined by squamous epithelium - usually.
  • +/-Inflammation.
• Connective tissue:
  • +/-Adipose tissue.
  • +/-Cartilage.
  • +/-Bone.
  • +/-Muscle.

DDx:

• Cystic squamous cell carcinoma - may be deceptively benign appearing.

Images

• BCC (flickr.com/Qiao).
• BCC (flickr.com/Qiao).

IHC

• p16 -ve.
  • May be done to exclude a HPV-associated head and neck squamous cell carcinoma.
• Ki-67 low.

See also

• Head and neck pathology.