EURORAD ESR

Case 14331

Fourth Branchial remnant anomaly

Author(s)
Apeksha Chaturvedi, MD

Strong Memorial Hospital, University of Rochester Medical Center; 601 Elmwood Ave 14642 Rochester, United States of America; Email:forapeksha@yahoo.com
 
Patient
female, 3 year(s)
 
 
  • Figure 1
    Contrast CT neck
     

    Coronal reconstructed image from contrast CT neck reveals a large, rim-enhancing fluid collection involving the left lobe of the thyroid.

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Computer Applications-Detection, diagnosis; Special Focus: Abscess;

    Axial image from contrast CT neck reveals a rim-enhancing, hypodense lesion involving the left lobe of the thyroid.

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Computer Applications-Detection, diagnosis; Special Focus: Abscess;

    Sagittal reconstructed image from the contrast CT of the neck reveals hypodense fluid collections tracking upward from the left lobe of thyroid in close proximity to the pyriform recess.

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Computer Applications-Detection, diagnosis; Special Focus: Abscess;

    Axial image from contrast CT neck (same patient) reveals a locule of air within this left neck fluid collection.

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Computer Applications-Detection, diagnosis; Special Focus: Abscess;
     
     
  • Figure 2
    Illustration depicting course of 4th branchial remnant anomaly.

    Fourth branchial remnant anomalies originate from the pyriform fossa, course in close proximity to thyroid gland into the mediastinum, and loop around and extend cephalad before ending in the neck.

     
    Area of Interest: Anatomy; Imaging Technique: Image manipulation / Reconstruction; Procedure: Computer Applications-3D; Special Focus: Congenital;
     
     
  • Figure 3
    Ultrasound of the left neck

    Ultrasound of the left neck reveals a large, fluid-filled region through the left lobe of thyroid corresponding to the abnormality seen by CT.

     
    Area of Interest: Ear / Nose / Throat; Imaging Technique: Ultrasound; Procedure: Computer Applications-Detection, diagnosis; Special Focus: Abscess;
     
     
Coronal reconstructed image from contrast CT neck reveals a large, rim-enhancing fluid collection involving the left lobe of the thyroid.
 
Axial image from contrast CT neck reveals a rim-enhancing, hypodense lesion involving the left lobe of the thyroid.
 
Sagittal reconstructed image from the contrast CT of the neck reveals hypodense fluid collections tracking upward from the left lobe of thyroid in close proximity to the pyriform recess.
 
Axial image from contrast CT neck (same patient) reveals a locule of air within this left neck fluid collection.
 
Fourth branchial remnant anomalies originate from the pyriform fossa, course in close proximity to thyroid gland into the mediastinum, and loop around and extend cephalad before ending in the neck.
 
Ultrasound of the left neck reveals a large, fluid-filled region through the left lobe of thyroid corresponding to the abnormality seen by CT.
 
 
 
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