Bronhogennaya cyst

bronhogennaya cystBronhogennaya cyst (side Gill cyst) - congenital cyst neck arising from the remnants existed in the embryonic period Gill pockets; is located at the inner edge of the sternoclavicular-liners muscles on the side of the neck as fluktuiruyushchimi tumors. Reaching significant proportions (figure), bronhogennaya cyst can compress the larynx, trachea, neurovascular bundle. With festering bronchogenic cysts and independent her autopsy formed persistent side fistulas (Gill fistula, or fistula), of which stands out sero-slimy liquid. Sometimes the inflammation of surrounding tissues. With long-term existence bronchogenic cysts possible malignant regeneration (see Bronhogenny cancer).
Treatment bronchogenic cysts and fistulas only online (delete). Conservative treatment in the form of cautery or curettage fistula sharp spoon is not effective.

Bronhogennaya cyst (from the Greek. branchia - gills, Gill slits and genos - origin - cyst formed from a closed on both sides branchiostegal side fistula (Gill fistula, or Gill fistula). The latter is a preserved in extrauterine period the balance of one of the Gill pockets. The location of the channel of the fistula and the level of the outlet are determined, he formed II or III Gill pocket. May be complete or incomplete bronhogenny fistula. Full has two holes on the lateral surface of the pharynx, larynx or trachea and the outer skin of the corresponding half of the neck along the sternoclavicular-liners muscles. More often incomplete Gill fistulas, closing the hole which is formed bronhogennaya cyst. K. Bronhogenny fistula and B. K. from the inside is lined with a cylindrical or atrial multi-layer flat epithelium in the subepithelial tissue lymphatic tissue in the form of follicles, even with the centers of reproduction, which is explained by the abundance of lymphatic tissue in the primary embryonic intestine, which is the source of education Gill pockets. The presence of lymph tissue in B. K. is a sign that distinguishes them from the middle of fistulas and cysts neck, genetically connected with Vice bookmarks thyroid gland. B. K. and fistulas can become inflamed, and to serve as a source of tumor development: bronhogenny papillary cystadenoma type teratoid tumors and branchiostegal cancer (see). Cm. also Gill arc gap.
Clinic bronchogenic cysts and fistulas. Bronhogenny fistulas are located on the side of the neck in the triangle bordered the middle line of the neck, inner edge of the sternoclavicular-liners muscles and collarbone, B. K. - between the sternoclavicular-liners muscle and the larynx. Up B. K. can reach styloid process, posterior to the pharynx, down to the jugular notch sternum. Cysts are rounded, the walls of their often intimately fused with a vascular bundle, but the skin above them is not changed and mobile. Consistency bronchogenic cysts elastic, sometimes you can catch the fluctuation.
The hole branchiostegal fistula is located on the inner edge of the sternoclavicular-liners muscles, usually at the bottom of the funnel retraction of the skin. From the fistula is allocated, as a rule, a small number of mucous fluid, but sometimes the selection is so abundant that occurs maceration of the skin and eczema. Careful palpation fistulous channel is defined as dense strand, which starts from the hole and is lost in the depth. Fistulous channel usually goes deep to the throat or at the back of the sternum. The length and direction of fistulous channel set cautious probing thin Pugovkina probe or fistulography.
Recognition bronhogenny fistulas are usually easy. In cases where fistula develops after the breakthrough B. K., it can be mixed with purulent fistula when lymphadenitis, but the nature of the discharge and histological examination of the inner wall of the fistula allow you to make a correct diagnosis. When Troubleshooting bronchogenic cysts need to exclude lymphangioma, blood cyst, bursitis, wandering tubercular abscess, lymphadenitis, sarcoma, and so on, Great value for diagnosis has puncture and examination of the received content.
Treatment bronchogenic cysts and fistulas only operational - delete all the cyst or the entire fistular channel so that even a small area of epithelial tissue, as this usually leads to relapse.
The operation, especially for long-existing fistula, is difficult because of their intimate relation to major blood vessels of the neck. Sometimes you need to be tied up and repetirovali with fistulous channel part of the jugular vein. Remember that bronhogenny fistula can be formed from glandular residues ductus thymopharingeus; in these cases, attaching a channel is directed to the breastbone (Venglovskii).