Neck Masses in Children

Question 1

where is a thyroglossal cyst located?

Answer 1

• anterior triangle
• usually in the midline
• below the hyoid

Question 2

what is the cause of thyroglossal cyst?

Answer 2

remnant of the thyroglossal duct

Question 3

what does echogenicity of a thyroglossal cyst on US suggest?

Answer 3

infection

Question 4

how does thyroglossal cyst appear on US?

Answer 4

• thin walled
• anechoic

Question 5

describe the pathophysiology of a brachial cyst

Answer 5

1. six brachial arches separated by branchial clefts
2. incomplete obliteration of the branchial apparatus
3. results in cysts, sinuses or fistulae

Question 6

what branchial cleft do branchial cysts commonly arise from?

Answer 6

2nd branchial cleft

Question 7

where are branchial cysts located?

Answer 7

located anterior to the sternocleidomastoid near the angle of the mandible

Question 8

how does branchial cyst appear on USS?

Answer 8

• similar consistency to water
• anechoic

Question 9

what are dermoids derived from?

Answer 9

pleuripotent stem cells

Question 10

where are dermoids located?

Answer 10

• midline
• commonly suprahyoid location

Question 11

how do dermoids appear on USS?

Answer 11

• heterogeneous appearance
• contain variable amounts of calcium and fat

Question 12

where are lymphatic malformations typically located?

Answer 12

posterior to the sternocleidomastoid

Question 13

what are cystic hygromas?

Answer 13

result from occlusion of lymphatic channels

Question 14

when do lymphatic malformations typically appear?

Answer 14

< 2 years old

Question 15

how do lymphatic malformations present?

Answer 15

painless, fluid filled lesions

Question 16

how do lymphatic malformations appear on USS?

Answer 16

hypoechoic

Question 17

where do infantile haemangiomas present?

Answer 17

either triangle of the neck

Question 18

how do infantile haemangiomas present?

Answer 18

grow rapidly initially and then will often spontaneously regress

Question 19

how do infantile haemangiomas present on x-ray?

Answer 19

• mass lesion
• containing calcified phleboliths

Question 20

where is lymphadenopathy located?

Answer 20

either triangle of the neck

Question 21

what are the causes of lymphadenopathy?

Answer 21

• reactive
• neoplastic