Neck Lumps Flashcards
Differentials by location:
Anywhere
Lipoma
Sebaceous (epidermoid) cyst. May have central punctum.
Differentials by location:
Midline
Thyroid: goitre, colloid nodule, adenoma, cancer, cyst.
Thyroglossal cyst.
Dermoid cyst. Rubbery and feels attached to underlying bone.
Differentials by location:
Anterior angle
Lymph node.
Branchial cyst.
Parotid tumour.
Carotid body tumour or carotid artery aneurysm (pulsatile).
Differentials by location:
Submandibular triangle sits within the anterior triangle:
- Lymph node.
* Salivary: stone, tumour, sialadenitis.
Differentials by location:
Posterior angle
- Cystic hygroma: a congenital lymphangioma, usually on left.
Lymphadenopathy
When examining lumps, what makes it almost certain of lymph nodes?
Having more than 1
Causes:
Inflammation
Infection
Infiltration
Autoimmune disease
EBV, TB, HIV
Lymphoma
Mets (GI, lung, head and neck)
New neck lumps that are suspicious for cancer
Lumps in older patients (>40yrs old)
Lumps in smokers
Painless lumps
Rubbery lumps - lymphoma
Investigations
Lump imaging:
What is first line?
What is a doppler US used for?
What bigger imaging can be used?
US
Doppler US for carotid body tumour or aneurysms
CT
MRI
Investigations:
Tissue sampling:
What is first line?
How are firm lumps sampled?
How can pharyngeal or laryngeal lumps be sampled?
Firm needle aspiration - usually done during USS
Incisional biopsy or excision biopsy
Biopsied through endoscopy