Branchial cleft cyst

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Branchial arch fistula
Bilateral Branchial Cleft Sinus fistulography right.jpg
Fistulography of a right branchial cleft sinus.
Classification and external resources
Specialty medical genetics
ICD-10 Q18.0 (ILDS Q18.020)
OMIM 113600
DiseasesDB 1588
MedlinePlus 001396
eMedicine derm/61 radio/107

A branchial cleft cyst is a congenital epithelial cyst that arises on the lateral part of the neck due to failure of obliteration of the second branchial cleft (or failure of fusion of the second and third branchial arches) in embryonic development.


The cyst wall is composed of either squamous or columnar cells with lymphoid infiltrate, often with prominent germinal centers. The cyst may contain granular and keratinaceous cellular debris. Cholesterol crystals may be found in the fluid extracted from a branchial cyst.


Branchial cleft cysts are remnants of embryonic development and result from a failure of obliteration of one of the branchial clefts, which in fish develop into gills.[1][2]



Most branchial cleft fistulae are asymptomatic, but they may become infected. The cyst, however, usually presents as a smooth, slowly enlarging lateral neck mass that may increase in size after an upper respiratory tract infection.[3]


Bilateral branchial cleft sinuses during surgery.

Conservative (i.e. no treatment), or surgical excision. As complete surgical excision may be difficult (due to the close proximity of the internal jugular vein and carotid vessels that lie deep to the swelling), they can recur.[4]

See also[edit]


  1. ^ Hong, Chih-ho. Branchial cleft cyst. URL: Accessed on: August 24, 2008.
  2. ^ Shubin, Neil "Your Inner Fish" 2009
  3. ^ Colman, Rebecca (2008). Toronto Notes. pp. OT33. 
  4. ^ Waldhausen JH (May 2006). "Branchial cleft and arch anomalies in children". Seminars in pediatric surgery 15 (2): 64–9. doi:10.1053/j.sempedsurg.2006.02.002. PMID 16616308. 

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