Neck Lumps Flashcards
Neck Lumps - Example Question
A 43-year-old man is referred by his GP with a 4 week history of a lump appearing on the right side of his neck. The lump is roughly 7 mm and is located on the right side of the thyroid gland, in the anterior triangle. It does not move when the patient sticks out his tongue, but it does move on swallowing. There is no history of weight loss of night sweats.
Blood tests are performed and reveal:
Hb 12.9 g/l Platelets 210 * 109/l WBC 6.0 * 109/l Na+ 141 mmol/l K+ 3.9 mmol/l Urea 4.1 mmol/l Creatinine 33 µmol/l
What is the most appropriate first-line investigation?
Radioisotope scan of thyroid Magnetic resonance scan of head and neck Excision biopsy Fine needle aspiration biopsy > Ultrasound scan of thyroid
High-resolution ultrasound scanning is an ideal first-line initial imaging investigation for most neck lumps. Because most lesions in the neck are site-specific, once a lesion has been located, specific ultrasound features can be used to establish the diagnosis.