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October 1992

A Nodule on the Side of the Neck in a Child

Author Affiliations

University of California, San Francisco

Arch Dermatol. 1992;128(10):1400. doi:10.1001/archderm.1992.01680200111021

REPORT OF A CASE  A 5-year-old white boy presented to the pediatric dermatology clinic with a somewhat tender nodule on the left side of his neck. His parents recalled that since birth he had had a small papule in this area. The papule remained unchanged until approximately 6 months before this visit, when a bluish nodule developed in the area. No discharge had been noted.On initial examination, the patient had a 0.5×0.5-cm, firm, freely mobile bluish nodule overlying the left sternocleidomastoid muscle (Fig 1). No ulceration or drainage was noted. The remainder of his skin examination was unremarkable. The nodule was excised in full and sent for routine histopathologic examination.The sections showed a cystic structure lined by pseudostratified ciliated columnar epithelium. Goblet cells were present focally. The overlying epidermis was normal. Histopathologic sections are shown in Figs 2 and 3.What is your diagnosis?

DIAGNOSIS:  Branchial cleft cyst.

DISCUSSION  Branchial cleft cysts are commonly present in the second and third decade. Patients usually note a stable swelling on the

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