Zyste oder Fistel des vierten Kiemenbogens

Branchial
cleft anomalies: a pictorial review of embryological development and spectrum of imaging findings. This 18-day-old baby presented with intermittent stridor. On examination, a left-sided oropharyngeal swelling was identified. The baby had initially required continuous positive airway pressure. Microlaryngobronchoscopy identified an internal opening arising from the pyriform sinus apex (black arrow; image courtesy of Mr Y. Bajaj). Axial and coronal T1 with coronal STIR imaging identified a likely air-containing structure (thick white arrows) extending from the pyriform sinus to the level of the left thyroid gland that was abnormally small (thin white arrow). This was surgically confirmed to represent a fourth branchial cleft sinus tract
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Toddler with
an infected neck mass. Coronal (above left), sagittal (above right) and axial (below) CT with contrast of the neck degraded by motion artifact shows a round, low density mass in the neck inferior to the hyoid bone and anterior to the thyroid gland that is just to the left of midline that has rim enhancement. Endoscopy subsequently showed a tract to the left pyriform sinus.The diagnosis was fourth branchial cleft cyst.
pediatricimaging.org • CC-by-nc-sa 4.0
Fourth
Branchial remnant anomaly. Coronal reconstructed image from contrast CT neck reveals a large, rim-enhancing fluid collection involving the left lobe of the thyroid.
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Fourth
Branchial remnant anomaly. Axial image from contrast CT neck reveals a rim-enhancing, hypodense lesion involving the left lobe of the thyroid.
www.eurorad.org • CC by-nc-sa-4.0
Fourth
Branchial remnant anomaly. Sagittal reconstructed image from the contrast CT of the neck reveals hypodense fluid collections tracking upward from the left lobe of thyroid in close proximity to the pyriform recess.
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Fourth
Branchial remnant anomaly. Axial image from contrast CT neck (same patient) reveals a locule of air within this left neck fluid collection.
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Fourth
Branchial remnant anomaly. Fourth branchial remnant anomalies originate from the pyriform fossa, course in close proximity to thyroid gland into the mediastinum, and loop around and extend cephalad before ending in the neck.
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Fourth
Branchial remnant anomaly. Ultrasound of the left neck reveals a large, fluid-filled region through the left lobe of thyroid corresponding to the abnormality seen by CT.
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Radiopaedia • CC-by-nc-sa 3.0 • de

Fourth branchial cleft cysts are very rare and parallel the course of the recurrent laryngeal nerve. They are most commonly on the left side (80%) and usually form a sinus which extends from the apex of the piriform sinus, as do third branchial cleft sinuses, but passes inferiorly rather than superiorly to reach anterior left upper thyroid lobe. Cysts can be anywhere in the neck down to the mediastinum, however, in most cases, they are located adjacent to the thyroid gland.

The proximity of the third and fourth branchial arches makes distinguishing third from fourth branchial cleft abnormalities radiologically difficult. For an accurate diagnosis, the relationship of the sinus tract to the superior laryngeal nerve must be determined surgically.

The most common presentation is abscess within or anterior to the left thyroid lobe.

See also

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Zyste oder Fistel des vierten Kiemenbogens:
Schwannom
 
www.eurorad.org • CC by-nc-sa-4.0
Schilddrüse
 
Wikipedia • Public domain
Aortenbogen
 
Wikipedia • CC BY-SA 3.0
zervikale
bronchogene Zyste
bmcpediatr.biomedcentral.com • CC-by-4.0
papilläres
Schilddrüsenkarzinom
Wikipedia • CC BY-SA 4.0
Ductus
thyreoglossus Zyste
insightsimaging.springeropen.com • CC-by-4.0
tuberkulöse
Halslymphknoten
insightsimaging.springeropen.com • CC-by-4.0