Cervical thymus

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Cervical lymph nodes for ultrasonography assessment.

Patient Data

Age: 5 years
Gender: Female
ultrasound

Ectopic cervical thymus, seen just below the left submandibular gland and anterior to the left carotid sheath.

Multiple enlarged cervical lymph nodes are noted with reactive features.

Case Discussion

The aim of the ultrasound examination was for assessment of cervical lymph nodes which revealed reactive cervical lymphadenitis. There is incidentally noted soft tissue structure at the left submandibular gland which is similar in texture and echogenicity to the thymus gland.

The normal thymus gland at the superior medistinum can be seen on neck ultrasound by tilting the probe downwards at the bese of the neck. On ultrasonography, it usually appears of mildly hypoechoic soft tissue structure with multiple discrete echogenic dots giving mottled appearance. Cervical thymus is a normal variant that is incidentally noted in neck imaging in pediatric age group. No further work up needed.

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