A 20-year-old man presents with a painless neck mass that has gradually increased in size. The mass is anteromedial to the right sternocleidomastoid muscle and has been present for 3 years. The mass increased in size and became more tender following an upper respiratory infection. An ultrasound of the neck identifies a single, round cystic mass with uniform, low echogenicity, and no internal septations. A contrast-enhanced CT scan of the neck shows a homogeneous mass with low attenuation centrally and with smooth rim enhancement. Which of the following is the most likely diagnosis?
AFirst branchial cleft cyst
BSternomastoid tumor
CSecond branchial cleft cyst
DEctopic thyroid tissue
ECervical lymphadenopathy
A 4-year-old girl is brought by her mother to the pediatrician for neck drainage. The mother reports that the child has always had a small pinpoint opening on the front of her neck, though the opening has never been symptomatic. The child developed a minor cold approximately 10 days ago which resolved after a week. However, over the past 2 days, the mother has noticed clear thick drainage from the opening on the child’s neck. The child is otherwise healthy. She had an uncomplicated birth and is currently in the 45th and 40th percentiles for height and weight, respectively. On examination, there is a small opening along the skin at the anterior border of the right sternocleidomastoid at the junction of the middle and lower thirds of the neck. There is some slight clear thick discharge from the opening. Palpation around the opening elicits a cough from the child. This patient’s condition is caused by tissue that also forms which of the following?
AEpithelial tonsillar lining
BThymus gland
CEpithelial lining of the Eustachian tube
DSuperior parathyroid glands
EInferior parathyroid glands
A 7-year-old boy is brought to the emergency department with a high fever and oxygen desaturation. He had a tracheostomy placed as an infant and has been placed on mechanical ventilation intermittently. Since then, he has had several bouts of pneumonia similar to his current presentation. In addition, he has been deaf since birth but is able to communicate through sign language. He attends school and performs above average for his grade. Physical exam reveals underdeveloped cheekbones, hypoplasia of the mandible, and malformed ears. Abnormal development of which of the following structures is most likely responsible for this patient's symptoms?
ABranchial cleft 1
BBranchial pouch 3
CBranchial arch 2
DBranchial arch 1
EBranchial pouch 1
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