The histological properties and possible origin of cervical thymus with cysts – A case report and hypotheses about its development

Varga, Ivan; Fědorová, Lenka; Klein, Martin; J, Babala; Jáger, René; Bódi, Ildikó

doi:10.1016/j.ijporl.2019.02.040

Cited by 3 publications

(2 citation statements)

References 35 publications

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“…During normal development, the paired thymic primordia descend from the angle of the mandible and fuse together at their final location in the superior mediastinum. 6 Disruptions in migration can result in an ectopic thymus, most commonly located in the cervical region or mediastinum. However, ectopic tissue can occur anywhere along this path of descent and has even been discovered within the thyroid itself.…”

Section: Discussionmentioning

confidence: 99%

“…These arches give rise to certain structures that are classically involved in 22q11.2 deletion syndrome: the great vessels of the heart, parathyroid glands, and thymus. During normal development, the paired thymic primordia descend from the angle of the mandible and fuse together at their final location in the superior mediastinum . Disruptions in migration can result in an ectopic thymus, most commonly located in the cervical region or mediastinum.…”

Section: Discussionmentioning

confidence: 99%

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Neck Mass in a Newborn With 22q11.2 Deletion Syndrome

Hamberis

Pecha

Discolo

2019

JAMA Otolaryngol Head Neck Surg

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An 11-day-old boy with 22q11.2 deletion syndrome, tetralogy of Fallot, and unilateral renal agenesis presented with a right neck mass and intermittent inspiratory stridor present at birth. The patient did not require positive pressure or intubation, but he had intermittent stridor associated with desaturations. He had feeding difficulty and failure to thrive. On physical examination, the newborn had facial dysmorphism, including a broad and flat nasal dorsum and mild micrognathia. Flexible fiberoptic laryngoscopy revealed a cystic lesion consistent with a vallecular cyst. A modified barium swallow study demonstrated laryngeal penetration and aspiration of thin and nectar-thick liquids. A diffuse, soft, palpable mass was present along the right neck.Magnetic resonance imaging (MRI) demonstrated a multispatial mildly enhancing mass within the bilateral retropharyngeal, parapharyngeal, and carotid spaces, with a mildly hyperintense signal relative to muscle on T1-weighted and T2-weighted images and associated restricted diffusion. The mass was largest on the right side, with convex borders, mild superior displacement of the right parotid gland, and posterior displacement of the right sternocleidomastoid muscle (Figure , A, B). The T2-weighted MRI also demonstrated a hyperintense, nonenhancing lesion within the base of the tongue consistent with a vallecular cyst. The thyroid appeared normal and in its expected location, but no thymus was present in the mediastinum. The patient was taken to the operating room for excision of the vallecular cyst, and a fine-needle aspiration biopsy of the right neck mass was performed for cytopathological analysis (Figure , C, D).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Neck Mass in a Newborn With 22q11.2 Deletion Syndrome

Hamberis

Pecha

Discolo

2019

JAMA Otolaryngol Head Neck Surg

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Cervical thymic cyst: A rare cause of neck mass in a female adolescent

Montgomery

Dukleska

Balarezo

et al. 2020

Journal of Pediatric Surgery Case Reports

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Enigmatic thymus: Variations in anatomical localisation of thymic tissue as an easily misdiagnosed congenital anomaly in surgical practice

Mayer,

Voller,

Varga

2024

World J Clin Cases

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We point out the issue of differential diagnosis regarding the finding of ectopically localised thymic tissue (a thymic cyst) in the neck. Thymic tissue can be found anywhere along its developmental tract of descent, from the angle of the mandible to the upper mediastinum. Disruption of the thymic descent can result in ectopically/abnormally localised islets of accessory thymic tissue, which may undergo cystic changes, as described in a case report by Sun et al . This anatomical variation of the thymus may be clinically misinterpreted as a neoplasm or other congenital anomalies as a branchial cyst, lymphatic malformation or cystic hygroma. The present editorial focuses on the challenge of establishing a diagnosis of ectopically localised tissue of thymus often presented as a lateral cervical mass, especially in the case of cystic variation/degeneration of this thymic tissue. We summarise hypotheses on the origin of such congenital cervical thymic cysts from the point of view of evolutionary history and embryology. We also discuss lesser-known facts about the anatomy, histopathology and developmental biology of the thymus as one of the most enigmatic organs in the human body.

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The histological properties and possible origin of cervical thymus with cysts – A case report and hypotheses about its development

Cited by 3 publications

References 35 publications

Neck Mass in a Newborn With 22q11.2 Deletion Syndrome

Neck Mass in a Newborn With 22q11.2 Deletion Syndrome

Cervical thymic cyst: A rare cause of neck mass in a female adolescent

Enigmatic thymus: Variations in anatomical localisation of thymic tissue as an easily misdiagnosed congenital anomaly in surgical practice

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