Lumps in neck

Question 1

carotid body tumour clinical features

Answer 1

painless, pulsatile neck Lump, bruit, slow growing, lyre sign, can be moved side to side but not up and down, may press on cranial nerves , vagus –> Horners

Question 2

lyre sign

Answer 2

characteristic finding on imaging investigations is splaying (separating) of the internal and external carotid arteries

Question 3

cystic hygroma

Answer 3

associated with turners sydnrome
<2 years old 
transilluminates
soft painless lump
posterior location

Question 4

thyroglossal lump

Answer 4

painless, midline, ascends both on swallow and tongue protrusion

Question 5

brachial cyst

Answer 5

round, soft, unilateral, often on the left, in people >10 y old, most common cause of lump in children, no movement on swallowing, intermittent swelling and infection

Question 6

Dermoid cyst

Answer 6

common in infancy and are benign teratomas that can be excised

Question 7

Chondroma

Answer 7

Rare midline neck lump, consisting of cartilaginous tissues. hard on palpation and move on swallowing

Question 8

Thyroid lump

Answer 8

midline neck lump, ascends on swallow but not on protrusion of the tongue

Question 9

Causes of goitre

Answer 9

Graves disease (hyperthyroidism)
Toxic multinodular goitre (hyperthyroidism)
Hashimoto’s thyroiditis (hypothyroidism)
Iodine deficiency
Lithium

Question 10

head and neck neoplasia features

Answer 10

hoarseness, throat pain, tongue ulcers or a painless neck lump and symptoms for longer than three weeks’ duration should prompt urgent referral.
They may present with weight loss and lymphadenopathy

Question 11

Investigation for a suspicious neck lump

Answer 11

ultrasound +/- fine needle aspiration (FNA)
CT or MRI