Parapharyngeal Second Branchial Cyst Manifesting as Cranial Nerve Palsies: MR Findings
Ji Hoon Shina,
Ho Kyu Leea,
Sang Yoon Kima,
Hyung Wook Parka,
Shin Kwang Khanga,
Choon Gon Choia and
Dae Chul Suha
a From the Departments of Radiology (J.H.S., H.K.L., C.G.C., D.C.S.), Otolaryngology (S.Y.K., H.W.P.), and Pathology (S.K.K.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
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FIG 1. A 35-year-old woman with hoarseness.
A, T1-weighted (627/15 [TR/TE]) axial MR image shows well-marginated mass (arrows) slightly hyperintense to the CSF in the right parapharyngeal space. The mass displaces parapharyngeal fat anteriorly (arrowhead) and compresses the lateral portion of the longus colli muscle. The mass also displaces both the right internal carotid artery and the right internal jugular vein to its posterolateral side (long arrow).
B, T2-weighted (3800/99) axial MR image shows the mass (arrows) is slightly hypointense to the CSF.
C, Contrast-enhanced T1-weighted (627/15) axial MR image reveals no definite enhancement of the mass (arrows).
D, T1-weighted (530/12) coronal MR image shows the mass (arrows) occupies the right parapharyngeal space from below the skull base to the hyoid bone level.
E, The STIR (6500/150/60 [TR/TI/TE]) coronal image shows the right side of the tongue has high signal intensity (arrows), suggesting denervation.
F, Photomicrograph (hematoxylin-eosin, original magnification x100) of the lesion shows a squamous epithelial-lined cyst wall (arrows), consistent with a branchial cleft cyst.
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