Presentation
Cervical swellings ?lymph nodes.
Patient Data
Ectopic cervical thymus gland, at the right submandibular region superficial to the right carotid sheath and posterior to the right submandibular gland, averaging 2 x 4 cm in axial dimensions, with normal appearance and no masses.
Multiple enlarged cervical lymph nodes, affecting all neck groups, with preserved oval shape and central fatty hilum, in keeping with reactive cervical lymphadenitis.
Case Discussion
There is incidentally noted soft tissue structure at the right submandibular region, superficial to the right carotid sheath and posterior to the right submandibular gland, which shows a similar texture and echogenicity as the thymus gland.
The comparison with the normal thymus gland at the superior medistinum helps to confirm the diagnosis of cervical thymus, by tilting the probe downwards at the base of the neck in the midline anterior position. On ultrasonography, it usually appears as a hypoechoic soft tissue structure with multiple discrete echogenic dots giving a mottled appearance and easy compressibility. Cervical thymus is a normal variant that is usually incidentally noted in neck imaging in the pediatric age group. No further work up needed.
The ultrasound examination also revealed reactive cervical lymphadenitis, which is common in children due to repeated upper respiratory tract infections.
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