Neck Lumps

Question 1

What are the 3 locations where neck lumps can be?

Answer 1

• Anterior triangle: mandible, midline and sternocleidomastoid
• Posterior triangle: clavicle, trapezius and sternocleidomastoid
• Midline

Question 2

What is the NICE guidelines for neck lump referral 2 week wait?

Answer 2

• Unexplained neck lump in anyone over 45
• Persistent unexplained neck lump at any age

Question 3

What is the urgent referral for US scan criteria?

Answer 3

• Any lump which is growing in size
• This should be within 2 weeks for patient 25 and older and within 48 hours for anyone <25

Question 4

How are neck lumps investigated?

Answer 4

• Bloods: FBC/Blood film
• HIV test
• TFTs
• US/CT/MRI
• Biopsy

Question 5

Differentials for neck lumps

Answer 5

• Reactive lymphadenopathy
• Lymphoma: rubbery, painless lymphadenopathy
• Thyroid swelling
• Thyroglossal cyst: more common in <20
• Pharyngeal pouch: more common in older men, usually not seen
• Cystic hygroma: congenital lesion on left side seen in babies/<2
• Cervical rib: more common in adult females