Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-14T00:14:45.322Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  29 June 2007

Jonathan Golledge  and
Harold Ellis
Jonathan Golledge*
Affiliation:
Department of Anatomy, University of Cambridge, and the Department of Otolaryngology, Bedford General Hospital, Bedford
Harold Ellis
Affiliation:
Department of Anatomy, University of Cambridge, and the Department of Otolaryngology, Bedford General Hospital, Bedford
*
Mr J.Golledge, The Department of Vascular Surgery, Ward B2, University Hospital of Wales, Heath Park, Cardiff CF4 4XW..
Get access Rights & Permissions [Opens in a new window]

Abstract

Four theories have been suggested to explain the aetiology of lateral cervical cysts. Ascherson (1832) suggested that the cysts arose due to incomplete obliteration of branchial cleft mucosa, which remained dormant until stimulated to grow later in life. His (1886) suggested these cysts were vestiges of the precervical sinus. Wenglowski (1912) believed lateral cervical cysts developed from the third pharyngeal pouch (thymopharyngeal duct).

A number of investigators during the 19th century noted the close relationship between lateral cervical cysts and lymphoid tissue (Lucke, 1861). Luschka (1848) suggested that cystic degeneration of cervical lymph nodes was the mechanism by which lateral cervical cysts were formed. This theory received little support until King (1949) studied the histology of a large number of lateral cervical cysts and concluded that these cysts resulted from cystic transformation of cervical lymph nodes.

The evidence for and against these theories of aetiology is discussed. The debate is centred on a study of 20 patients with lateral cervical cysts operated on in the Department of Otolaryngology, Bedford Hospital, between January 1986 and December 1991. In all twenty cases the wall of the cyst was found to be composed of lymphoid tissue, histologically identical to that present in lymph nodes. The mean age of presentation was 31 years, and in no case was a tract or cord found which connected the cyst to the skin or pharynx.

The evidence strongly suggests that lateral cervical cysts develop from the cystic transformation of cervical lymph nodes. Mechanisms by which this may occur are discussed.

Keywords

Branchioma, aetiology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 108 , Issue 8 , August 1994 , pp. 653 - 659
Copyright
Copyright © JLO (1984) Limited 1994

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.)

Footnotes

Presented at the British Association of Clinical Anatomists meeting, at The Royal London Hospital, 17 December 1992.

References

Ascherson, F. M. (1832) De fistulis colli congenitis adjecta fissurarum branchialium in mammalibus avibusque historia succincta. C. H. Jonas, Berolini, pp 1–21.Google Scholar
Bailey, H. (1922) The clinical aspects of branchial cysts. British Journal of Surgery 10: 565–572.CrossRefGoogle Scholar
Bhaskar, S. W., Bernier, J. L. (1958) Lympho-epithelial lesions of salivary glands. Cancer 11: 1156–1179.Google Scholar
Bhaskar, S. W., Bernier, J. L. (1959) Histogenesis of branchial cysts: a report of 468 cases. American Journal of Pathology 35: 407–414.Google ScholarPubMed
Boyd, W. (1986) Boyd's Pathology for the Surgeon. 8th Edition, ch. 11 (Anderson, W., ed.), Saunders, London, pp 145–147.Google Scholar
Cheeseman, A. D., Holden, H. B., Richards, A. E. S. (1992) The neck. In Bailey and Love's Short Practise of Surgery. 21st Edition, ch. 35 (Mann, C. V., Russell, R. C. G., eds.), Chapman and Hall Medical, London, pp 720–721.Google Scholar
Crocker, J., Jenkins, R. (1985) An immunohistochemical study of branchial cysts. Journal of Clinical Pathology 38: 784–790.CrossRefGoogle ScholarPubMed
Doi, O., Hutson, J. M., Myers, N. A., McKelvie, P. A. (1988) Branchial remnants: a review of 58 cases. Journal of Paediatric Surgery 13: 789–792.CrossRefGoogle Scholar
Ellis, P. D. M. (1987) Branchial cleft anomalies, thyroglossal cysts and fistulae. In Scott-Brown's Otolaryngology. 5th Edition, vol. 6, ch. 20 (Kerr, A. G., ed.), Butterworth, London, pp 297–304.Google Scholar
Finn, D. G., Buchalter, I. H., Romo, T., Sarti, E., Chodosh, P. (1987) First branchial cleft cysts: clinical update. Laryngoscope 97: 136–140.CrossRefGoogle ScholarPubMed
Frazer, J. E. (1923) Nomenclature of diseased states caused by certain vestigial structures in the neck. British Journal of Surgery 11: 131–136.CrossRefGoogle Scholar
Frazer, J. E. (1926) The disappearance of the pre-cervical sinus. Journal of Anatomy 61: 132–143.Google Scholar
Fujibayashi, T., Itoh, H. (1981) Lymphoepithelial (branchial) cyst within the parotid gland. Report of a case and review of the literature. International Journal of Oral Surgery 10: 283–292.CrossRefGoogle ScholarPubMed
Gosain, A. K., Wildes, T. O. (1988) Lateral cervical cysts containing gastric epithelium. Archives of Pathological Laboratory Medicine 112: 96–98.Google ScholarPubMed
Heusinger, R. (1864) Hals-Kiemen-fisteln von noch nicht beobachteter form. Archiv fur Pathologische, Anatomie und Physiologie und fur Klinische Medicin 29: 358–380.Google Scholar
Hirota, J., Maeda, Y., Ueta, E., Osaki, T. (1989) Immunohistochemical and histologic study of cervical lymphoepithelial cysts. Journal of Oral Pathological Medicine 18: 202–205.CrossRefGoogle ScholarPubMed
His, W. (1886) Ueber der Sinus praecervicalis und uber die Thymusanlage. Archiv fur Anatomie und Entwickelungsgeschichte, 9: 421–433.Google Scholar
Howie, A. J., Proops, D. W. (1982) The definition of branchial cysts. sinuses and fistulae. Clinical Otolaryngology 7: 51–57.CrossRefGoogle ScholarPubMed
Hunczovsky, J. N. (1785) Anweisung zu chirurgischen operationen. Wien, Graffer, pp 312–332.Google Scholar
King, E. S. J. (1949) The lateral lympho-epithelial cyst of the neck (‘branchial’ cyst). Australian and New Zealand Journal of Surgery 21: 109–121.CrossRefGoogle Scholar
Langenbeck, B. (1859) Exstirpation einer Dermoidcyste von der Scheide der grossen Halsgefasse. Verwundung der Vena jugularis communis. Stillung der Blutung durch Compression. Heilung. Archiv fur Klinische Chirurgie 1: 1–25.Google Scholar
Lucke, A. I. (1861) Ueber atheromysten der Lymphdrusen. Archiv fur Klinische Chirurgie 1: 356–365.Google Scholar
Luschka, H. (1848) Ueber fistula colli congenita. Archiv fur Physiologische Heilkunde 7: 25–27.Google Scholar
Maran, A. G. D., Buchanan, D. R. (1978) Branchial cysts, sinuses and fistulae. Clinical Otolaryngology 3: 77–92.CrossRefGoogle ScholarPubMed
Meyer, H. W. (1932) Congenital cysts and fistulae of the neck. Annals of Surgery XCV: 1–26.CrossRefGoogle Scholar
Morrish, T. N., Manning, S. C. (1991) Branchial anomaly in a newborn presenting as stridor. International Journal of Paediatric Otorhinolaryngology 21: 259–262.CrossRefGoogle Scholar
Neel, H. B., Dej Pemberton, J. (1945) Lateral cervical (branchial) cysts and fistulas. A clinical and pathologic study. Surgery 18(3): 267–285.Google Scholar
Rathke, M. H. (1828) Ueber das Dasein von Kiemenandeutungen bei menschlichen Embryonen. Isis von Oken 21: 108–109.Google Scholar
Sadler, T. W. (1990) Longman's Medical Embryology. 6th Edition, ch. 16, Williams and Wilkins, London, pp 308–310.Google Scholar
Scott, R. (1987) Branchial cysts in the parotid gland. Journal of the Royal College of Surgeons of Edinburgh 32: 336–338.Google ScholarPubMed
Schede, M. (1872) Ueber die tiefen Atherome des Halses. Archiv fur Klinische Chirurgie 14: 1–22.Google Scholar
Senn, N. (1884) On branchial cysts of the neck. Journal of the American Medical Association 3(8): 197–209.CrossRefGoogle Scholar
Smith, T. (1866) On congenital cystic tumours – article 2. St Bartholomew's Hospital Reports 2: 16–35.Google Scholar
Virchow (1866) Ein tiefes auriulares Dermoid des Halses. Virchows Archiv fur Pathologische Anatomie und Physiologie 35: 208–214.CrossRefGoogle Scholar
Walter, J. B., Israel, M. S. (1987) General Pathology, 6th Edition, ch. 27. Churchill-Livingstone, London, p 384.Google Scholar
Wenglowski, R. (1912) Ueber die Halsfisteln und Cysten. Langenbeck. Archiv fur Klinische Chirurgie 98: 151–208.Google Scholar
Wild, G.Mischke, D., Lobeck, H., Kastenbauer, E. (1987) The lateral cyst of the neck: congenital or acquired? Acta Otolaryngology 103: 546–550.Google ScholarPubMed
Work, W. (1972) Newer concepts of first branchial cleft defects. Laryngoscope 82: 1581–1593.CrossRefGoogle ScholarPubMed
Wyman, A., Dunn, L. K., Talati, V. R., Rogers, K. (1988) Lymphoepithelial ‘branchial’ cysts within the parotid gland. British Journal of Surgery 75: 818–819.CrossRefGoogle ScholarPubMed