Neck Masses Flashcards
Describe the etiology & risk factors of a branchial cleft cyst
- MC congenital neck mass in kids
- 2-3% bilateral, clusters
- unknown embryonic changes during gestation
Describe the clinical presentation of a branchial cleft cyst
- fluctuant fluid filled sac of epithelial cells and lymph cells anterior to the SCM
- can present with URI sxs
- can develop fistula to skin/sinus
Describe the treatment for branchial cleft cyst
refer to ENT for surgical excision (can lead to infection)
Describe the etiology/risk factors for thyroglossal duct cysts
- midline anterior neck mass from leftover thyroid cells
- usually in childhood prior to 10 y/o
- embryonic remnant from failure of thyroglossal duct closure
Describe the clinical presentation of thyroglossal duct cysts
- can be asymptomatic
- dysphagia if enlarged or infected
- may go undiagnosed until ill
Describe the treatment for thyroglossal duct cysts
refer to ENT for surgical removal (1-2% can have carcinoma)
Describe the etiology/risk factors for viral adenopathy
- most common cause of neck masses in peds
- adenovirus, rhinovirus, enterovirus, influenza, HSV, CMV, EBV
Describe the clinical presentation of viral adenopathy
- bilateral, tender, soft/rubbery submandibular lymph node groups
- 1-1.5cm in size
- sometimes constitutional sxs, myalgia, diarrhea, conjunctivitis, oral sores, rash, h/a, otalgia
Describe the treatment for viral adenopathy
treat symptoms
Describe the etiology/risk factors for bacterial lymphadenopathy
- usually suppurative LAD from skin/pharynx
- staph aureus, GABHS most common, MRSA if recent hosp, anaerobic from dental procedure, mycobacterium from soil/water
Describe the clinical presentation of bacterial lymphadenopathy
bilateral tender soft/rubbery submandibular lymph node groups
Describe the diagnostic testing for bacterial lymphadenopathy
WBC, CRP, procalc, BC, rapid strep test
Describe the etiology/risk factors for parotitis
- inflammation of parotid gland
- bacterial (staph or anaerobe) or viral
- secondary to new anticholinergic med, post op, dehydration, poor dental hygiene
Describe the clinical presentation of parotitis
- sialadentitis: inflammation of salivary gland
- firm, swollen, tender, parotid gland
- f/s/c
Describe the diagnostic testing for parotitis
amylase, WBC, PCR, +/- CT
Describe the treatment for parotitis
- inpt for severely ill pts with IV abx
- OP with oral abx (clindamycin + ciprofloxacin)
- hydration, massage, sialogogues, peridex