Images below require Macromedia's Flash Player to view

Neuroradiology Case of the Week

Case 390

March 2009

Hisao Nakamura, MD

Clinical Presentation: Patient is a 52-year-old male with non-small cell lung cancer and metastasis. This study was requested for evaluation of leptomeningeal disease.

Imaging Findings: Nasopharyngeal cyst.     

Diagnosis: Nasopharyngeal branchial cyst

Discussion: Cystic lesions of the nasopharynx include such rare conditions as encephalocele, sphenoid sinus mucocele, chordoma, cystic degeneration of a nasopharyngeal tumor and the extension of a pituitary tumor. Tornwaldt’s cysts and a Rathke’s pouch cyst are situated in the midline posterior-superior wall of the nasopharynx. Adenoid retention cysts, usually found in the same region as Tornwaldt 's cysts, are surrounded by abundant lymphoid tissue. Nasopharyngeal branchial cysts usually occur in the lateral wall of the nasopharynx. Several case reports described that cysts extend from the lateral wall between Rosenmuller to the upper pole of the tonsil.
     Because the diagnosis of the present case does not support the histological findings, the branchial cyst is diagnosed considering the location.

References:

1. Tamagawa Y, Kitamura K, Miyata M. Branchial cyst of the nasopharynx: resection via the endonasal approach. J Laryngol Otol. 1995 Feb;109(2):139-41. [PubMed]
2. Ben Salem D, Duvillard C, Assous D, Ballester M, Krausé D, Ricolfi F. Imaging of nasopharyngeal cysts and bursae. Eur Radiol. 2006 Oct;16(10):2249-58. [PubMed]