Presentation
Left sided neck swelling.
Patient Data
A cystic lesion is noted in the left posterior cervical space, deep to the sternomastoid, and measuring 4 x 4 x 6 cm. It shows fine internal septations and water-like signal in all pulse sequences. One of the locules (inferior) shows high T1 signal suggestive of proteinaceous or hemorrhagic content. No post-Gadolinium enhancement. No cervical lymphadenopathies. The other neck spaces are unremarkable.
Case Discussion
Cystic hygroma / lymphangioma is a type of lymphatic malformations that appears as an insinuating multiloculated cystic mass at superficial and deep neck spaces (trans-spatial). Being infrahyoid, a posterior location is more common. It can show fluid/fluid levels. High T1 fluid content reflects hemorrhagic or proteinaceous nature.
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