Pérez J A, Henning E, Valencia V, Schultz C
Instituto de Cirugía, Facultad de Medicina, Universidad Austral de Chile, Hospital Base de Valdivia.
Rev Med Chil. 1994 Jul;122(7):782-7.
The aim of this work was to analyze retrospectively the clinical features of 32 patients aged 23.9 years (21 female) with the histological diagnosis of second branchial cleft cyst. In 28 patients, the cyst was localized below the mandibular angle. The presenting symptom was a cervical tumor in 30 patients and pain in eight. Fourteen aspiration punctures was performed obtaining 8 purulent and 6 straw colored aspirates. The preoperative diagnosis was correctly made in only 19 patients; the principal confounding diagnosis was tuberculous adenitis. All patients were operated performing a complete cystectomy in 30 and partial cystectomy in two. Three patients had a surgical wound infection and the cysts recurred 5 months and 4 years after operation in the two patients subjected to partial cystectomy. The histological study revealed squamous epithelial with underlying lymphoid tissue. It is concluded that aspiration puncture is useful for the correct diagnosis and that the cyst must be completely eradicated to avoid recurrences.
本研究旨在回顾性分析32例经组织学诊断为第二鳃裂囊肿的患者的临床特征，患者平均年龄23.9岁，其中女性21例。28例患者的囊肿位于下颌角下方。30例患者的主要症状为颈部肿物，8例患者有疼痛症状。共进行了14次穿刺抽吸，其中8次抽出脓液，6次抽出草黄色液体。仅19例患者术前诊断正确；主要的混淆诊断为结核性腺炎。所有患者均接受手术治疗，30例行完整囊肿切除术，2例行部分囊肿切除术。3例患者出现手术切口感染，2例行部分囊肿切除术的患者术后5个月和4年囊肿复发。组织学研究显示囊肿内衬鳞状上皮，其下为淋巴组织。研究得出结论，穿刺抽吸有助于正确诊断，且必须彻底切除囊肿以避免复发。
