Neck swellings Flashcards
Where is the anterior triangle?
Lateral border SCM
Medial is midline
Where is the posterior triangle?
Clavicle inferiorly
Lateral - anterior border of trapezius
Medial - lateral border of SCM
Which swellings are found superficially?
Sebaceous cysts
Lipomas
Neurofibromas
Which swellings are found in the midline?
Thyroid
Thyroglossal cyst
Dermoid cyst
What swellings could be present in the anterior triangle?
Salivary glands
Lymph nodes
Branchial cyst
Carotid body tumour
What swellings are present in the posterior triangle?
Lymph nodes
Cystic hygroma
Which points in a Hx are important if symptom is cervical lymphadenopathy?
Fever, weight loss
Hoarseness, dyspnoea
melena, recent immigrant
What investigations are needed if cervical lymphadenopathy?
CXR Fine needle aspiration Mantoux test or ZN stain Check hepatospenomegaly Check other nodes
What is evident in examination of a thyroglossal cyst?
Moves with the tongue
Below hyoid
Presents in teenage years
What is the treatment for a thyroglossal cyst?
Excision
What are the features of a dermoid cyst?
Presents in youth Soft Non-fluctant In midline Also found lateral to eye
What is a branchial cyst?
Persistent part of 2nd branchial arch.
Teenage years
Half filled water bottle
What may be contained in a branchial cyst?
Cholesterol crystals
What is a caution with branchial cysts?
May fistulate to skin and leak saliva
Where do cystic hygromas present?
Posterior triangle
In whom do cystic hygromas present?
infants
What are the features of cystic hygromas?
Lymph filled.
Transilluminable
Pressure symptoms
What is the treatment for cystic hygromas?
Will shrink over time so just leave it
Which cancer is most likely to appear on the ectopic thyroid tissue?
Papillary
If the swelling moves on swallowing where it is likely to be?
Thyroid
If the swelling move on sticking the tongue out what is not likely to be?
Dermoid cyst
What is a chemodactoma?
Carotid body tumour
If a swelling is soft, is it likely to be benign or malignant?
Benign
What is Trosier’s sign?
Presence of Virchow’s node
What is the structure called in the mouth which contains all the tonsils?
Waldeyer’s tonsillar ring
Histologically, what kind of cancer is likely to be found in the oesophagus?
Squamous epithelial
Where else can cystic hygromas present?
Axilla
What parts of the history are particularly important in thyroid swellings?
FHx
Previous neck irradiation
True or False
Hoarseness could be either benign or malignant
False.
Mostly malignant.
Which nerve infiltration causes hoarseness?
recurrent laryngeal
Which investigations should be done in a thyroid swelling?
TSH
USS-FNA
What are the 5 responses of FNA?
Thy1- inadequate
Thy2- benign
Thy 3- suspicious
Thy4/5 malignant
What further investigation is carried out in Thy3?
Thyroid lobectomy
