Neck lumps Flashcards
There are three descriptions to note the location of a neck lump. What are they?
- Anterior triangle
- Posterior triangle
- Midline
What are the borders of the anterior triangle?
- Mandible
- Midline of neck
- Sternocleidomastoid
What are the borders of the posterior triangle?
- Clavicle
- Trapezius
- Sternocleidomastoid
How can the causes of lymphadenopathy be classified?
- Reactive lymph nodes (e.g. viral URTI, tonsillitis)
- Infected (e.g. TB, infectious mononucleosis)
- Inflammatory (e.g. SLE, sarcoidosis)
- Malignancy (e.g. lymphoma, leukaemia, mets)
Give three causes of a goitre
- Grave’s disease (hyperthyroidism)
- Toxic multinodular goitre (hyperthyroidism)
- Hashimoto’s thyroiditis (hypothyroidism)
What is a goitre?
Generalised swelling of the thyroid gland
Give three causes of individual thyroid lumps
- Thyroid cysts
- Thyroid adenoma
- Thyroid carcinoma (papillary or follicular)
The three salivary gland locations are the…
- Parotid glands
- Submandibular glands
- Sublingual glands
The salivary glands can enlarge for three main reasons…
- Stones (sialolithiasis)
- Infection
- Tumours
What is the carotid body?
A structure located just above the carotid bifurcation, made up of glomus cells
Groups of glomus cells are known as
Paraganglia
How are carotid body tumours formed?
Excessive growth of glomus cells
Give two features of a carotid body tumour which can be found O/E
- Pulsatile
- Associated with a bruit on auscultation
Carotid body tumours may compress which nerves?
CN IX, X, XI, XII:
- Glossopharyngeal
- Vagus
- Accessory
- Hypoglossal
Compression of the vagus nerve by a carotid body tumour may produce which syndrome?
Horner’s syndrome:
- Ptosis
- Miosis (constriction)
- Anhidrosis
Describe the management of most carotid body tumours
Surgical removal
What is a lipoma?
A benign tumour of fat (adipose) tissue
What is a thyroglossal cyst?
- Congenital abnormality
- Arises when the thyroglossal duct persists (should normally disappear during foetal development)
- Fluid filled cyst forms
Describe the key finding on examination which distinguishes a thyroglossal cyst from other causes of neck lump
Thyroglossal cysts move up and down with movement of the tongue
What is a branchial cyst?
- Congenital abnormality
- Arises when the second branchial cleft fails to form properly during foetal development
- Fluid-filled cyst forms
A branchial cyst will transilluminate. True or false?
True
What are the causes of a lump in the neck?
- Lymphadenopathy
- Lipoma
- Thyroid gland pathology
- Salivary gland pathology
- Carotid body tumour
- Congenital abnormalities (e.g. thyroglossal cyst, branchial cyst)
