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Case report of a p16INK4A-positive branchial cleft cyst

Published online by Cambridge University Press:  25 May 2015

T McLean ,
C Iseli ,
D Amott  and
M Taylor
T McLean
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Austin Hospital, Heidelberg, Melbourne
C Iseli
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Austin Hospital, Heidelberg, Melbourne
D Amott*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Austin Hospital, Heidelberg, Melbourne Department of Otolaryngology-Head and Neck Surgery, The Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia
M Taylor
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Austin Hospital, Heidelberg, Melbourne
*
Address for correspondence: Dr D Amott Department of Otolaryngology-Head and Neck Surgery, The Royal Melbourne Hospital, 300 Grattan St Parkville, Melbourne 3052, Victoria, Australia Fax: +61 3 9375 2486 E-mail: dhamott@hotmail.com
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Abstract

Objective:

To report the occurrence of a concurrent oropharyngeal papilloma and branchial cleft cyst linked by p16INK4A and human papillomavirus immunohistochemistry.

Case report:

A 42-year-old woman presented with a 1-month history of a left lateral neck mass. Contrast enhanced computed tomography showed a hypodense lesion 20 mm in diameter anteromedial to the left sternocleidomastoid muscle. Ultrasound-guided fine needle aspiration suggested a branchial cleft cyst. Panendoscopy was performed at the time of neck mass removal, and a papillomatous lesion was removed from the left hypopharynx. Histopathological analysis showed the neck lesion to be a branchial cyst containing lymphoid tissue, and the oral lesion to be a squamous papilloma. Immunohistochemical analysis showed both the branchial cleft cyst and papilloma to be positive for p16INK4A expression and human papillomavirus DNA.

Conclusion:

Histological and immunohistochemical analyses support the cystic transformation of lymph nodes, or the ‘Inclusion Theory’, as the aetiology of branchial apparatus anomalies, and raise the possibility that human papillomavirus infection may play a much larger role in disease of the head and neck than previously supposed.

Keywords

Papillomaviridaep16INK4ABranchioma
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 6 , June 2015 , pp. 611 - 613
Copyright
Copyright © JLO (1984) Limited 2015 

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