A 15-year-old boy was diagnosed with a cystic parotid mass, which was initially thought to be a first branchial cleft cyst. The mass was treated with antibiotics and fully resolved on examination and imaging. The mass returned, and a superficial parotidectomy was performed to remove the suspected branchial cleft cyst. Final pathology demonstrated a B-cell lymphoblastic lymphoma. Bilateral bone marrow biopsies and peripheral blood counts were negative for any malignancy. This case demonstrates a rare presentation of primary parotid B-cell lymphoblastic lymphoma that began as a fluctuating cystic parotid mass consistent in appearance with a first branchial cleft cyst. Laryngoscope, 2017
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