Neck Lumps

Question 1

Reactive lymphadenopathy

Answer 1

Most common

History of local infection/generalised viral infection

Question 2

Lymphoma

Answer 2

Rubbery, painless lymphadenopathy
Night sweats
Splenomegaly
Weight loss
Anorexia

Question 3

Thyroid swelling

Answer 3

Symptomatically hypo.hyperthyroidism

Moves upwards when swallowing

Question 4

Thyroglossal cyst

Answer 4

<20yrs
Usually midline between isthmus of thyroid and hyoid bone
Moves upwards with tongue protrusion

Embyronic remnant from formation of thyroid which begins at the foramen ccecum in the tongue and moves down the neck canal (thyroglossal duct) usually disappears

Question 5

Pharyngeal pouch

Answer 5

• Older men
• Posteromedial herniation between thyropharyngeus and cricopharyngeus muscles

Midline lmup, gurgles on palpation

CF: dysphagia, regurgitation, aspiration, chronic cough

Question 6

Cystic hygroma

Answer 6

Classically found in left posterior triangle
Congenital lymphatic lesion (lymphangioma)
Most evident at birth (90% before 2 years)

Question 7

Branchial cyst

Answer 7

An oval mobile cystic mass that develops between the sternocleidomastoid muscle and pharynx

Develops due to obliteration of second brancial cleft in embryonic development

Usually present in early adult hood

Question 8

Cervical rib

Answer 8

More common in adult females

10% thoracic outlet syndrome

Question 9

Carotid aneurysm

Answer 9

Pulsatile lateral neck mass, doesn’t move on swallowing