Cystic hygroma is most characteristically described as what type of cervical lesion on ultrasound?

• A. Multiloculated anechoic cervical mass with a thin surrounding membrane
• B. Solid neck mass with vascularity
• C. Cystic lesion in the liver
• D. Pleural effusion

Answer: (A)

Cystic hygroma is a congenital lymphatic malformation that occupies the cervicofacial region. On ultrasound it classically appears as a multiloculated, anechoic (fluid-filled) cervical mass with thin, well-defined walls. The multiple internal compartments come from septations within the lymphatic channels, giving a chart of several small cystic spaces rather than a single fluid cavity. Because it’s lymphatic tissue rather than blood-filled, it often shows minimal internal vascularity on Doppler. This combination—location in the neck, a multiloculated cystic appearance, and thin surrounding walls—is what makes it the best fit for describing cystic hygroma.

The other options don’t fit: a solid neck mass with vascularity suggests a vascular tumor or solid lesion, a cystic lesion in the liver is not in the neck, and a pleural effusion is a thoracic finding, not a neck lesion.