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Branchial cyst (histological suspect of Castleman disease): differential diagnosis of a lymphoma
Introduction Branchial cysts are a developmental abnormality arising in the early prenatal period between the 4. and the 8. week, typically failure of obliteration of the second branchial cleft. The most commonly differential diagnoses are the lymphadenopathy and the neoplasia, that can be seen from infant age to old people.
Case report A 54 years old patient present himself with a cervical swelling at the right side of the neck since 7 months. This swelling progressed in that period of time slowly but without complaints. The clinical examination showed a not painful elastic tumor about 4x2x4 cm dorsal to the sternocleidomastoid muscle. The rest of the examination was normal. The ultrasound of the neck showed in the region V at the right side an about 4,2x4,1x3,9 cm, echo poor tumor with sharp and smooth borders and no perfusion. Based on the clinical and sonographically findings and under the diagnosis of a bronchial cyst was a surgical extirpation of the cystic tumor performed. The histological result was a suspicion of Castleman disease of the hyaline-vascular type.
Discussion The differential diagnoses of a bronchial cyst include the lymphoma and Castleman disease. A fine needle aspiration (FNA) can help to secure the diagnosis before the operation.
Article published online:
10 June 2020
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