An immunohistochemical study of branchial cysts.

Abstract

SUMMARY Twenty five specimens of branchial cyst from the same number of patients have been examined. On staining with haematoxylin and eosin a consistent finding was that the mural lymphoid follicles were always aligned with their mantle zones towards the luminal epithelium. With conventional staining lymphatic sinuses were noted in 17 of the specimens, but with immunohistochemical staining these structures were apparent in 23 cysts. Their frequent occurrence in branchial cysts supports the theory that these lesions are derived from epithelial inclusions in lymph nodes. Immunohistochemical techniques for a range of other markers, using polyclonal and monoclonal antisera, showed a distribution of lymphoid and non-lymphoid tissue elements, as seen in lymph nodes and, for example, palatine tonsils. The lining luminal epithelium also shared many features in common with the crypt epithelium of tonsils. 28 February 1985 antigens: K and X immunoglobulin light chains; y, a, ,t, 8, and e immunoglobulin heavy chains; factor VIII related antigen; muramidase; a,-antitrypsin; and S-100 protein. The primary antisera used were polyclonal; they were raised in rabbits and obtained commercially from Mercia Brocades, Weybridge, Surrey, UK. The primary antisera were applied at suitable titres for 20 min after trypsinisation and blocking of endogenous peroxidase with the hydrochloric acid and methanol technique. After a thorough wash swine antirabbit antiserum was applied for 20 min; this was followed by another wash in Tris buffer at pH 7-6. Rabbit PAP was then applied for a further 20 min, followed by a final wash in buffer. The peroxidase was visualised by the usual 3,3'-diaminobenzidine (DAB) reaction, and the sections were counterstained in haematoxylin, washed, dehydrated, cleared, and mounted in synthetic medium.In addition, polyclonal antisera to cathepsin B, cathepsin G, and leucocyte elastase were applied. These were raised in sheep and generously supplied by the

The aetiology of lateral cervical (branchial) cysts: past and present theories

“…The characteristics of this lymphoid wall are identical to those of a lymph node (Hirota et al, 1989). Lymphoid follicles, marginal sinuses, immunoglobulins and T-lymphocytes are present (Crocker and Jenkins, 1985). The distribution of cells corresponds to that of a reactive lymph node (Figure 7).…”

From the Archives of the AFIP

“…This orientation is analogous to that of the normal crypt epithelium of the palatine tonsils and marginal sinuses in lymph nodes (38). This orientation is analogous to that of the normal crypt epithelium of the palatine tonsils and marginal sinuses in lymph nodes (38).…”

Cystic Tumors of the Neck

“…Microscopic examination shows the cyst wall to be composed of stratified squamous epithelial lining and underlying lymphoid tissue 6 . Immunohistochemical staining in one series showed lymphatic sinuses in branchial cysts, with mural lymphoid follicles always aligning their mantle zones toward luminal epithelium 12 . These are features of lymph nodes and tonsillar tissues.…”

“…Most branchial cleft cysts originate from the second branchial apparatus, perhaps from buried epithelial cell rests or from epithelial inclusions in lymph nodes 12 . They present as painless fluctuant, smooth neck masses usually below the angle of the mandible along the anterior border of the sternocleidomastoid muscle.…”