CT and MRI manifestation of branchial cleft fistula / 实用放射学杂志

Objective To discuss the diagnostic value of branchial cleft fistula with CT and(or)MRI.Methods CT and(or)MRI findings of 33 cases of branchial cleft fistula were collected and analyzed retrospectively.Results Branchial cleft fistula were divided into four types namely first,second,third and fourth according to its origin with each type having its own corresponding CT and MRI features.Among the 33 cases,7 cases (21%)were first branchial cleft fistula,which originated from external auditory meatus and the parotid gland.These lesions presented as a tubular structure around the ear,sometimes invading the facial nerve,causing facial nerve symptoms.1 8 cases (5 5 %)were second branchial cleft fistula,and were presented as tubular ones in the anterior triangle area of the neck or along the anterior border of the sternocleidomastoid muscle.8 cases (24%)were third or fourth branchial cleft fistula,which were difficult to differentiate,both of them originated from pyriform sinus and partly penetrated the thyroid.Conclusion CT and(or) MRI could show the location and range of the lesion clearly,making it valuable for diagnosis of branchial cleft fistula.

A Case of Actinomycotic Thyroiditis in a Child with Fourth Branchial Cleft Fistula / 소아과

Fistulas of the fourth branchial pouch have an external opening in the neck and the inner opening at the apex of the pyriform fossa. The tract passes from the left lobe of the thyroid, resulting in acute suppurative thyroiditis in most cases. Actinomycosis is an indolent, slowly progressive infection caused by anaerobic or microaerophilic gram-positive bacteria, primarily of the genus Actinomyces. These bacteria are filamentous with branching and may colonize in the oral cavity. Actinomycosis is a chronic disease characterized by abscess formation, tissue fibrosis, and draining sinuses. We experienced a case of 6-year-old boy who had presented with a left neck mass. Neck sono showed an approximately 3 cm-sized low echoic mass in the left thyroid gland. Thyroid scan was compatible with thyroid hypofunction. Gomori-methenamine silver stain after fine needle aspiration showed colonies of bacteria, are composed of long, thin, filamentous bacteria. Barium esophagogram showed a linear barium-filled track at the left pyriform sinus. Neck excisional biopsy was consistent with the remnant of a fourth branchial cleft fistula. We report a case of actinomycotic thyroiditis in a child with fourth branchial cleft fistula, with a brief review of related literature.

A Case of Branchial cleft fistula / 대한피부과학회지

Congenital branchial anomalies are developmental defects resulting from incomplete obliteration of branchial clefts, arches and pouches, and usually found as cysts, fistulas and sinuses. The sinus or fistula is usually noted during infancy and young childhood due to recurrent infection. We have experienced a case of branchial cleft fistula in a 12-year-old male. It was a skin colored, nontender nodule which had mucus secreting from a small opening pore. We performed complete surgical removal and histopathologically the lumen was lined by pseudostratified columnar cells and the stroma was composed of aggregates of lymphocytes with many germinal centers. So we finally diagnosed it as branchial cleft fistula of second type branchial anomaly.