[2] Neck Lumps Flashcards

1
Q

What are most neck lumps caused by?

A

A benign cause

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2
Q

Why is thorough assessment of neck lumps necessary?

A

Because it could be due to more serious disease

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3
Q

What is the most common cause of neck lumps?

A

Reactive lymph nodes

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4
Q

What are the most common causes of reactive lymph nodes?

A
  • Bacterial
  • Viral
  • Parasitic
  • Non-infective causes
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5
Q

What are the common bacterial causes of reactive neck lymph nodes?

A
  • Beta haemolytic strep
  • Staph aureus
  • Tuberculosis
  • Secondary syphilis
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6
Q

What are the common viral causes of reactive neck lymph nodes?

A
  • URTI viruses
  • EBV
  • CMV
  • HIV
  • HSV
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7
Q

What are the common parasitic causes of neck reactive lymph nodes?

A
  • Head lice
  • Fungal infections
  • Toxoplasmosis
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8
Q

What are the common non-infective causes of reactive neck lymph nodes?

A
  • Sarcoidosis

- Connective tissue disease

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9
Q

What are some rare types of neck lumps?

A
  • Malignant lymph nodes
  • Infections of the skin
  • Lipomas and other benign tumours
  • Thyroid swellings
  • Salivary gland problems
  • Congenital swellings
  • Developmental abnormalities
  • Carotid aneurysm or tumour
  • Malignant tumours
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10
Q

What can cause malignant cervical lymph nodes?

A
  • Leukaemia
  • Lymphoma
  • Metastases
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11
Q

What infections of the skin can cause neck lumps?

A
  • Abscess

- Infected sebaceous cyst

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12
Q

What benign tumours can cause neck lumps?

A
  • Lipomas
  • Fibromas
  • Chondromas
  • Neuromas
  • Vascular tumours
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13
Q

What types of thyroid swellings can cause neck lumps?

A
  • Diffuse enlargement
  • Nodules
  • Cancers
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14
Q

What salivary gland problems can cause neck lumps?

A
  • Tumours
  • Blocked ducts
  • Infection and inflammation
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15
Q

What congenital swellings can cause neck lumps?

A
  • Thyroglossal cyst
  • Dermoid cyst
  • Cystic hygrometer
  • Lymphangioma
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16
Q

What developmental problems can cause neck lumps?

A
  • Branchial cyst
  • Laryngocoele
  • Pharyngeal pouch
  • Cervical rib
17
Q

What malignant tumours can cause neck lumps?

A
  • Sarcoma
  • Chondrosarcoma
  • Skin malignancy
18
Q

What factors should be considered when assessing history of a neck lump?

A
  • Age of patient
  • Onset
  • Consistency and mobility
  • Location
  • Associated symptoms
19
Q

What type of neck lumps are more common in young people?

A

Inflammatory (more common than malignant)

20
Q

What types of neck lumps are common in children and young people?

A

Congenital and developmental causes

21
Q

What is the typical natural history of inflammatory neck lumps?

A
  • Sudden onset

- Resolution in 2-6 weeks

22
Q

What does progressive enlargement over short period of time suggest of a neck lump?

A

More likely to be malignant

23
Q

What features of history suggest salivary gland problem as a cause of neck lump?

A

Transient with association with eating

24
Q

What is a hard neck lump more likely to be?

A

Malignancy

25
How do congenital masses usually feel?
Smooth and mobile
26
How can thyroid gland swellings and thyroglossal cysts be identified on examination?
They move when swallowing (thyroglossal cysts move when tongue moved out)
27
What does a tender neck lump suggest?
Infection
28
What are midline lumps more likely to be?
Thyroid in origin
29
What a posterior triangle lumps most commonly?
Lymph nodes
30
What are bilateral swellings across the mandibular angles likely to be?
Parotid infection
31
What can submandibular swellings be related to?
The submandibular gland
32
What can a lump in the left supraclavicular ross indicate?
Infraclavicular metastatic malignancy
33
What are some red flag symptoms of haematological malignancies?
- Night sweats - Weight loss - Pruritis - Fever - Bruising - Breathlessness - Fatigue
34
What investigations can be used to differentiate neck lumps?
- FBC and ESR - TFT - Viral serology - Throat swab - CXR - USS - Radionucleotide scanning - CT or MRI
35
Where should neck lumps be referred?
ENT but also dermatology, oral surgeon or chest physician depending on suspected cause
36
When should an urgent 2WW referral be made for patients with a neck lump?
- Lost weight - Hoarseness, dysphagia or dyspnoea for >3 weeks - Symptoms of haematological malignancy - Unexplained large lymph node - Suspicious clinical features - Diagnosis unclear