True about branchial cyst; is all except
BRANCHIAL CLEFT REMNANTS :
• Branchial cleft remnants typically present as a lateral neck mass on a toddler.
• Structures of the head and neck are derived from 6 pairs of branchial arches, their intervening clefts and pouches.
• Congenital cysts, sinuses, or fistulas result from failure of these structures to regress, persisting in an aberrant location.
• All branchial remnants are present at the time of birth; however, they are often not recognized until later in life.
• These lesions may present as sinuses, fistulas, or cartilaginous rests in infants.
• They occur more commonly as cysts in older children and adolescents.
• Clinical presentation may range from a continuous mucoid drainage from a fistula or sinus to the development of a cystic mass that may become infected.
• Branchial remnants may also be palpable as cartilaginous lumps or cords corresponding with a fistulous tract. Dermal pits or skin tags may also be evident.
Arise from lower third of sternocleidomastoid
Peak age of presentation is 3rd decade
Cyst wall consists of lymphoid tissue
Fluid contains cholesterol crystal