neck lumps

Question 1

what is branchial cyst

Answer 1

benign, developmental defect of the branchial cyst

Question 2

location of branchial cysts

Answer 2

anterior to the sternocleidomastoid muslce

Question 3

examination findings in branchial cysts

Answer 3

unilateral (typically left)
slowly enlarging
smooth, soft fluctuant
non-tender
fistula
no movement on swallowing
no transillumination

Question 4

congenital neck lumps in children

Answer 4

branchial cysts
thyroglossal cysts
dermoid cyst
vascular malformation

Question 5

investigations for branchial cysts

Answer 5

consider and exclude malignancy
ultrasound
referral to ENT
FNA

Question 6

presentation of reactive lymphadenopathy

Answer 6

most common
history of local infection or generalised viral illness

Question 7

presentation of lymphoma

Answer 7

rubbery, painless lymphadenopathy
pain when drinking alcohol (uncommon)
night sweats and splenomegaly

Question 8

presentation of thyroglossal cyst

Answer 8

patients <20
midline (between isthmus of thyroid and hyoid bone)
moves upwards with protrusion of the tongue
may be painful if infected

Question 9

presentation of pharyngeal pouch

Answer 9

more common in older men
usually not seen but if large then midline lump that gurgles on palpation
dysphagia, regurgitation, aspiration and chronic cough

Question 10

what is a pharyngeal pouch

Answer 10

posteromedial herniation between thyropharyngeus and cricopharyngeus muscles

Question 11

cystic hygroma

Answer 11

congenital lymphatic lesion typically found in the neck, on the left side
evident at birth, or present before 2 years old

Question 12

cervical rib

Answer 12

more common in adult females
10% develop thoracic outlet syndrome