A 43 year old man presented with a pulsatile swelling over the left side of neck since one year
Lyre, a Greek musical instrument
Ultrasonography of the neck shows a well-defined, circular hypoechoic lesion at the bifurcation of the left common carotid artery. It measures approximately 2.9 × 3 × 4 cm and shows internal vascularity. It splays the common carotid bifurcation- displacing the Internal carotid laterally and the external carotid artery medially (Lyre sign).
MRI of the neck shows a well-defined lobulated soft tissue mass in the carotid space at the level of the carotid bifurcation . The lesion is markedly hyperintense on T2-weighted images with multiple internal flow voids, giving a “salt and pepper” appearance.