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ENT > Neck lumps > Flashcards

Neck lumps Flashcards

1
Q

Lumps that can appear anywhere (2)

A

lipomas

sebacious cysts

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2
Q

Features of lipomas (4)

A

soft, fluctuant lump

skin can be “pinched off” it

benign

often present for many yrs

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3
Q

Features of and epidemiology of sebacious cysts (6)

A

hard lump w. smooth surface

punctum

mobile

within skin

non-tender

more commonly affects males

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4
Q

Causes of midline masses (6)

A

if <20yrs:

  • dermoid cyst
  • thyroglossal cyst

if>20 yrs:

  • thyroid mass
  • chondroma
  • pharyngeal pouch
  • laryngocele
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5
Q

Features of dermoid cysts (2)

A

teratoma (mature)

large, hard midline lump

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6
Q

Pathology, features and Ix of thyroglossal cysts (4)

A

due to thyroglossal duct which pulls thyroid down from tongue remaining patent>cyst formation

move on protrusion of tongue

transilluminates

in children do radioiodine uptake scan to ensure they have functioning thyroid.

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7
Q

Features and subtypes of thyroid masses (5)

A

move up on swallowing,

not on tongue protrusion

papilloma

anaplastic

follicular

medullary

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8
Q

Features of thyroid papilloma (4)

A

most common

20-55yrs

often multifocal

cells have finger-like projections, ground glass nuclei and psammoma bodies

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9
Q

Features and presentation of anaplastic thyroid ca. (6)

A

most dangerous

rare

> 65yrs

hard, irregular lump

locally invasive

presents w. sudden onset wt. loss and hoarse voice w. surrounding lymphadenopathy.

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10
Q

Features of follicular thyroid ca.

A

can’t Dx w. FNA

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11
Q

Features of medullary thyroid ca. (2)

A

(C cell)
assoc. w. MEN2a

presents w. diarrhoea

assoc. w. CEA

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12
Q

Features of chondromas (2)

A

hard, bony lump

benign cartilaginous tumour

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13
Q

Features of pharyngeal pouches (2)

A

halitosis (bad breath)

gurgles on palpation

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14
Q

Pathology and features of laryngoceles (3)

A

outpouching of larynx from pressure

smooth, reducible lump

causes discomfort
(think trombone players)

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15
Q

Causes of neck lumps in submandibular triangle (6)

A

benign lymphadenopathy-most common cause

malignant lymphadenopathy

submandibular salivary stone

tumour

sialadenitis

cervical rib

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16
Q

Causes of benign submandibular lymphadenopathy (5)

A

TV

viruses: EBV, CMV HIV

bartonella (cat scratch)

toxoplasmosis

lymphoma

17
Q

Features of malignant submandibular lymphadenopathy (2)

A

firm

non-tender

18
Q

Features of submandibular salivary stones (3)

A

calculus in submandibular salivary gland

dull pain and swelling

intense pain may occur after eating

19
Q

Features of sialadenitis

A

inflamed salivary gland

20
Q

Causes of anterior triangle lumps (3)

A

branchial cysts

carotid body paraganlgiomas

carotid artery aneurysms

21
Q

Pathology and features of branchial cysts (4)

A

due to failure of obliteration of 2nd branchial cleft in embryological development

oval, fluctuant, cystic, non-tender mass

between pharynx and sternocleidomastoid

can become infected>fistula

22
Q

Epidemiology and common presentation of branchial cysts (2)

A

M>F

often present w. URTI

23
Q

Ix and Rx of branchial cysts

A

aspiration>cholesterol crystals

Rx w. sclerotherapy or surgery, aspiration not sufficient

24
Q

Features of carotid body paraganliomas (5)

A

tumour of carotid body

hard

pulsatile w. no bruit

move horizontally but not vertically

more common at high altitude

25
Q

Features of carotid artery aneurysms (4)

A

pulsatile

bruit

soft and fluctuant

w/i anterior triangle

26
Q

Ix for carotid artery aneurysms (2)

A

digital subtraction angiography 1st line

can also do doppler US

27
Q

Causes of posterior triangle masses (5)

A

LNs

lymphoma

cystic hygroma

sternocleidomastoid tumour of infancy

cervical rib

28
Q

Features and Rx of cystic hygromas (5)

A

soft lump

transilluminates brightly

multiple cyst-like cavities containing lymph

common in babies/neonates

can be drained/Mx w. sclerosing agents

29
Q

Features and Rx of sternocleidomastoid tumours of infancy (5)

A

presents between 2wks-3mo

palpable, hard, mobile and painless

felt in lower middle third of sternocleidomastoid

assoc. w. congenital torticollis

benign, Rx w. physio and stretching.

30
Q

Sx of cervical ribs (2)

A

due to compression-thoracic outlet syndrome:

  • wasting of intrinsic hand muscles (brachial plexus)
  • Raynaud’s (subclavian artery)
31
Q

Ix for neck lumps (6)

A

US for consistency but can’t Dx

biopsy is gold standard: FNAC/core biopsy

CT to show exact location

virology: HPV, EBV

Mantoux for TB

CXR for TB/sarcoid.

ENT (11 decks)

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