2.1.4 Neck Lumps Flashcards
How do you approach a neck lump?
History
Age
Duration
Progression
Associated Symptoms (red flags?)
Potential risk factors H&N cancers?)
Examination
Midline or lateral?
If lateral, anterior or posterior triangle?
Is there movement with swallowing? (thyroid)
Moves with sticking out tongue (thyroglossal duct cyst)
(goitre is enveloped in investing fascia so will also move, use history to differentiate)
Palpate and note features
Features of palpation
Superficial?
Mobile or fixed?
Hard or soft?
Smooth or irregular?
Fluctuant (is it filled with fluid)?
Tender?
Overlying skin changes (red)?
What are the possible causes of neck lumps?
- Benign skin/subcutaneous tissue lesions (sebaceous cysts, lipoma)
- Cervical lymphadeonapthy (reactive or malignant)
- Congenital lesions (thyroglossal duct cysts, branchial cysts, dermoid cysts)
- Thyroid pathology (malrigant or benign neoplasms, Graves or Hashimotos)
- Salivary gland pathology (calculis, inflammation or infection, neoplasm ,benign or malignant)
- Vascular carotid body tumour, carotid artery aneurysm if PULSATILE - moves side to side but not up and down
What are the causes of midline neck lumps?
Thyroid disease
Congenital lesions, dermoid cyst or thyroglossal duct cyst
What is this?
What is this?
What is this?
What are some causes of lateral neck lumps?
Salivary gland pathology (anterior)
Carotid Body tumour
Congenital lesions
Branchial Cyst (anterior)
Cystic Hygroma (posterior)
What is this?
What is this?
What is this?
What is this?
What is the first line imaging for investigating neck lumps?
Ultrasound- no radiation, quick, easy can be used for guided fine needle aspiration
