Ectopic Cervical Thymus

Scott, Kirby J.; Schroeder, Ashley A.; Greinwald, John H.

doi:10.1001/archotol.128.6.714

Cited by 33 publications

(4 citation statements)

References 13 publications

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“…The thymic primordia forms from the ventral aspect of the third and fourth pharyngeal pouch. In the sixth week, the thymopharyngeal duct forms and gradually detaches from the pharynx, forming a tube‐like structure that migrates caudally toward the mediastinum . Arrest of migration in the superior neck may leave patients with Type D lesions, which tend to be larger in size and are typically diagnosed at a young age.…”

Section: Discussionmentioning

confidence: 99%

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Ectopic cervical thymus in children: Clinical and radiographic features

et al. 2019

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Objectives: Ectopic thymus is rare and can be a diagnostic challenge. This study evaluated the management of children radiographically diagnosed with ectopic cervical thymus.Methods: A retrospective review of 100 patients was performed. Data related to clinical presentation, radiological imaging, pathology, and management were collected. Changes in lesion volume were tracked over time. Clinical characteristics were compared based on lesion location in the neck using analysis of variance modelling.Results: There were 115 lesions with radiographic features of ectopic cervical thymus (15 children had bilateral lesions). Diagnosis was based on ultrasound in 98% of patients, magnetic resonance imaging in 18%, and computed tomography in 11%. Mean (SD) follow-up duration was 2 (2.2) years. Forty-four percent (51/115) of lesions involved the thyroid gland, 29% (33/115) were in the central neck but separate from the thyroid, 18% (21/115) had mediastinal extension, and 8% (9/115) involved the submandibular region. Location was unclear for two patients. Submandibular lesions were on average 12.4 cm 3 larger (95% CI, 8.2, 16.6) than mediastinal lesions at diagnosis, P ≤ .001. Volume of thymic tissue decreased over time, from a mean (standard deviation [SD]) volume of 4.3 cm 3 (9.2) at initial ultrasound to 2.7 cm 3 (6.1) at final ultrasound (paired t-test, P = .008). Only two patients required surgery: one for compressive symptoms, and the other to rule out malignancy.Conclusion: Ninety-eight percent of children with ectopic cervical thymus were managed conservatively without issues. We propose a classification system based on location to ease communication among clinicians and to help follow these lesions over time.

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Section: Discussionmentioning

confidence: 99%

“…Around the 10th week of gestation, solid cords connecting the primordia to the pharynx are obliterated . Remnants of these solid cords in the central neck may produce Type C lesions if they are associated with the thyroid gland, or Type B lesions if not.…”

Section: Discussionmentioning

confidence: 99%

Ectopic cervical thymus in children: Clinical and radiographic features

et al. 2019

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“…A cystic lesion is the more common sonographic appearance. 7 However, it is the solid lesion that is often concerning for more serious pathologies such as malignant masses. Ultrasound appearance of the solid ectopic thymus is similar to that of the normal mediastinal thymus.…”

Section: Discussionmentioning

confidence: 99%

Ectopic cervical thymus: Recognising the characteristic ‘embroidery yarn’ appearance on ultrasound

Krishnan,

Ram,

Rana

et al. 2024

Ultrasound

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Introduction: The thymus normally forms in the neck from the third pharyngeal pouch and descends to its normal position in the mediastinum. Arrest of descent or sequestration of thymic tissue can occur at any point along its path leading to an ectopic thymus which can present as a neck mass, usually in the paediatric age group. Purpose and Case Report: Ultrasound is generally performed in the presence of a neck mass in children. Although a characteristic ‘starry sky’ appearance of the thymus has been described on ultrasound, it is not considered sufficiently specific and cross-sectional imaging with magnetic resonance imaging is usually performed. On magnetic resonance imaging, the ectopic thymus appears as a homogeneous T1 isointense and T2 hyperintense mass and may actually appear ominous due to the tendency of ectopic thymus to sometimes show diffusion restriction unlike the normal thymus. Subsequent invasive biopsy or surgical removal is usually necessary to rule out a neoplastic lesion. In our observation, the ultrasound appearance of thymus is sufficiently distinctive to be confidently diagnosed as ectopic thymic tissue. This appearance is similar to the high-resolution appearance of an embroidery yarn. The reason most radiologists are not aware of the same is because the normal mediastinal thymus is not usually imaged by ultrasound. Conclusion: An accurate diagnosis on ultrasound would mean avoidance of expensive cross-sectional imaging and invasive biopsy or surgical excision in favour of regular non-invasive follow-up ultrasound scans until the lesion involutes in late childhood.

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“…Cervical thymus although a rare entity should be kept in the differential diagnosis of asymptomatic neck masses in children. [10] e unique imaging findings on ultrasound and MRI paralleling that of the normal thymus tissue should aid to confidently establish the diagnosis. e radiologist must be aware of the condition and the typical normal appearance of thymus which can obviate the need for biopsy or surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

A “no-touch” neck “mass” in a child

Kanamathareddy

Irodi

Mathai

et al. 2023

CRCR

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Aberrant cervical thymus is a rare cause of pediatric neck masses related to the embryological development. In most of the cases, this condition is asymptomatic and essentially benign in nature. Here, we describe the sonological and magnetic resonance imaging (MRI) features of cervical thymus in a 2-month-old baby who presented with the left submandibular swelling. The unique imaging findings on ultrasound and MRI paralleling that of the normal thymus tissue were helpful in confidently establishing the diagnosis. Therefore, the radiologist must be aware of the condition and the typical normal appearance of thymus which can obviate the need for biopsy or surgical intervention.

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Ectopic Cervical Thymus

Cited by 33 publications

References 13 publications

Ectopic cervical thymus in children: Clinical and radiographic features

Ectopic cervical thymus in children: Clinical and radiographic features

Ectopic cervical thymus: Recognising the characteristic ‘embroidery yarn’ appearance on ultrasound

A “no-touch” neck “mass” in a child

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