Differential diagnosis of pediatric cystic neck masses

• Branchial cleft cyst (type 1, type 2, type 3, type 4)
• Lymphatic malformation
• Lymphadenopathy with abscess
• Ranula
• Thyroglossal duct cyst

Approach to the differential diagnosis of cystic neck masses:

• Thyroglossal duct cyst is most commonly in the midline
• Branchial cleft cyst is most commonly lateral to the midline
• Lymphatic malformation is a transpatial mass that is multicystic
• Any cystic neck mass may be infected at presentation
• Lymphadenopathy containing an abscess is usually surrounded by severe inflammatory change