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AJNR - American Journal of Neuroradiology

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Intrathyroidal Lymphoepithelial (Branchial) Cyst: Sonographic Features of a Rare Lesion

Anil T. Ahuja^,a, Alexander R. Chang^a, Edward To^a, Peter Pang^a, Alex S.C. Ching^a, Ann D. King^a and Con Metreweli^a

^a From the Departments of Diagnostic Radiology and Organ Imaging (A.T.A., A.S.C.C., A.D.K., C.M.), Anatomical and Cellular Pathology (A.R.C.), and Surgery (E.T., P.P.), Chinese University of Hong Kong, Shatin, N.T., Hong Kong.

View larger version (79K): [in a new window]   FIG 1. Transverse sonogram of thyroid showing multiloculated nodule (black arrows). Note homogeneous internal architecture and presence of comet tail artifact within (small white arrows) created by cholesterol crystals. This represents the pseudosolid appearance of a congenital neck cyst. Transducer pressure on nodule produces shifting of contents, suggesting its cystic nature. Aspiration yielded viscous yellowish puslike fluid. Open arrow identifies internal jugular vein, and large white arrow marks common carotid artery.FIG 2. Clump of mature squamous cells (hematoxylin and eosin stain; original magnification, x200).FIG 3. T2-weighted (2500/100 [TR/TE]; number of acquisitions, two) axial-view image obtained through thyroid shows well-defined, markedly hyperintense cystic nodule (arrows) in right lobe of thyroid. There are no other specific features to suggest that it may be of congenital origin

View larger version (223K): [in a new window]   FIG 4. T1-weighted (500/20; number of acquisitions, one) coronal-view image shows multiloculated, slightly hyperintense nodule (arrows) in right lobe of the thyroid

View larger version (118K): [in a new window]   FIG 5. Higher-power view shows squamous epithelium (arrows) and desquamating keratin (arrowheads). Lymphocytes are seen in the underlying connective tissue (hematoxylin and eosin stain; original magnification, x250).FIG 6. Thyroid follicles of variable size (arrows) can be seen in this view. Some are compressed by diffuse lymphocyte infiltrate (large arrows) (hematoxylin and eosin stain; original magnification, x100)