Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-24T16:46:32.322Z Has data issue: false hasContentIssue false

Ectopic cervical thymus: case report and review of pathogenesis and management

Published online by Cambridge University Press:  11 December 2009

F Ahsan*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Fifth Floor Riverside Block, Christchurch Hospital, Christchurch, New Zealand
R Allison
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Fifth Floor Riverside Block, Christchurch Hospital, Christchurch, New Zealand
J White
Affiliation:
Histopathology Department, Southern Community Laboratories, Christchurch, New Zealand
*
Address for correspondence: Mr Farhan Ahsan, Clinical Fellow, Otolaryngology-Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, 5th Floor Riverside Block, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand. E-mail: [email protected]

Abstract

Objective:

Ectopic cervical thymus is a rare anomaly, and 50 per cent of cases occur in children. The aim of this report was to remind clinicians of this rare condition, which is part of the differential diagnosis of a paediatric neck lump.

Method:

Case report together with literature review of the pathogenesis and management of ectopic cervical thymus.

Results:

The ectopic cervical thymus is a rare cause of a benign neck mass, and is thus usually misdiagnosed as lymphadenopathy or neoplasia. We discuss its embryology, aetiology, presentation, histopathology, radiology and management, with reference to the reported case.

Conclusion:

Ectopic cervical thymus should always be considered in the differential diagnosis of a paediatric neck lump. The diagnosis can often be confirmed by cytology and radiology prior to surgical excision.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Cacciaguerra, S, Rizzo, L, Tranchina, MG, Cutrona, D, Di Benedetto, A. Ultrasound features of ectopic cervical thymus in a child. Pediatr Surg Int 1998;13:597–9CrossRefGoogle ScholarPubMed
2 Kacker, A, April, M, Markentel, CB, Breuer, F. Ectopic thymus presenting as a solid submandibular neck mass in an infant: case report and review of literature. Int J Pediatr Otorhinolaryngol 1999;49:241–5CrossRefGoogle Scholar
3 Sadler, TW. Langman's Medical Embryology, 5th edn. Baltimore: Williams & Wilkins, 1985;281–9Google Scholar
4 Tovi, F, Mares, AJ. The aberrant cervical thymus. Embryology, pathology and clinical implications. Am J Surg 1978;136:631–7CrossRefGoogle ScholarPubMed
5 Spigland, N, Bensoussan, AL, Blanchard, H, Russo, P. Aberrant cervical thymus in children: three case reports and review of literature. J Pediatr Surg 1990;25:1196–9CrossRefGoogle Scholar
6 Castleman, B. Atlas of Tumors Pathology. Tumours of the Thymus Gland. Washington DC: Armed Forces Institute of Pathology, 1955;2367Google Scholar
7 Tunkel, DE, Erozan, YS, Weir, EG. Ectopic cervical thymic tissue. Diagnosis by fine needle aspiration. Arch Pathol Lab Med 2001;125:278–81CrossRefGoogle ScholarPubMed
8 Wagner, CW, Vincour, CD, Weintraub, WH, Golladay, ES. Respiratory complications in cervical thymic cysts. J Pediatr Surg 1988;23:657–60CrossRefGoogle ScholarPubMed
9 Guba, AM, Adam, AE, Jaques, DA, Chambers, RG. Cervical presentation of thymic cysts. Am J Surg 1978;136:430–6CrossRefGoogle ScholarPubMed
10 Miller, MB, Devito, MA. Cervical thymic cyst. Otolaryngol Head Neck Surg 1995;112:585–8Google ScholarPubMed
11 Warwick, R, Williams, PL, eds. Gray's Anatomy, 35th British edn. Philadelphia: WB Saunders, 1973;725Google Scholar
12 Shah, UK, Fuleihan, NS, Handler, SD, Kallman, JE, Fear, DR. Pathologic Quiz case 2. Arch Otolaryngol Head Neck Surg 1999;125:695, 697CrossRefGoogle ScholarPubMed
13 Zielke, AM, Swischuk, LE, Hernandez, JA. Ectopic cervical thymic tissue: can imaging obviate biopsy and surgical removal? Pediatr Radiol 2007;37:1174–7CrossRefGoogle ScholarPubMed
14 Han, BK, Suh, Y, Yoon, H. Thymic ultrasound 1. Intrathymic anatomy in infants. Pediatr Radiol 2001;31:474–9CrossRefGoogle Scholar
15 Han, BK, Suh, Y, Yoon, H. Thymic ultrasound. II Diagnosis of aberrant cervical thymus. Pediatr Radiol 2001;31:480–7CrossRefGoogle ScholarPubMed
16 Slovis, TL, Meza, M, Kuhn, JP. Aberrant thymus – MR assessment. Pediatr Radiol 1992;22:490–2CrossRefGoogle ScholarPubMed
17 Cohen, MD, Weber, TR, Sequeira, FW, Vane, DW, King, H. The diagnostic dilemma of the posterior mediastinal thymus: CT manifestation. Radiology 1983;146:691–2CrossRefGoogle Scholar
18 Rollins, NK, Currarino, G. Case report: MR imaging of posterior mediastinal thymus. J Comput Assist Tomogr 1988;12:518–20CrossRefGoogle ScholarPubMed
19 Khariwala, SS, Nicollas, R, Triglia, JM, Garabedian, EN, Marianowski, R, Van Den Abbeele, T et al. Cervical presentations of thymic anomalies in children. Int J Pediatr Otorhinolaryngol 2004;68:909–14CrossRefGoogle ScholarPubMed
20 Mikal, S. Cervical thymic cyst. Arch Surg 1974;109:558–62CrossRefGoogle ScholarPubMed
21 Wells, WJ, Parkman, R, Smogorzewska, E, Barr, M. Neonatal thymectomy: does it affect immune function? J Thorac Cardiovasc Surg 1998;115:1041–6CrossRefGoogle ScholarPubMed
22 Ramos, SBV, Barcia, AB, Viana, SR. Phonotypic and functional evaluation of natural killer cells in thymectomised children. Clin Immunol Immunopathol 1996;81:277–81CrossRefGoogle Scholar
23 Brearly, S, Gentle, TA, Baynham, MI, Roberts, KD, Abrams, LD, Thompson, RA. Immunodefiency following neonatal thymectomy in man. Clin Exp Immunol 1987;70:3227Google Scholar