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Neck Lumps - Differentials (Pharyngeal Pouch (More common in older men,…
Neck Lumps - Differentials
Reactive Lymphadenopathy
By far the most common cause of neck swellings.There may be a history of local infection or a generalised viral illness
Lymphoma
Rubbery, painless lymphadenopathy
The phenomenon of pain whilst drinking alcohol is very uncommon
There may be associated night sweats and splenomegaly
Thyroid Swelling/Goitre
May be hypo-, eu- or hyperthyroid symptomatically
Moves upwards on swallowing
Thyroglossal Cyst
More common in patients < 20 years old
Usually midline, between the isthmus of the thyroid and the hyoid bone
Moves upwards with protrusion of the tongue
May be painful if infected
Pharyngeal Pouch
More common in older men
Represents a posteromedial herniation between thyropharyngeus and cricopharyngeus muscles
Usually not seen but if large then a midline lump in the neck that gurgles on palpation
Typical symptoms are dysphagia, regurgitation, aspiration and chronic cough
Usually left sided
Cystic Hygroma
A congenital lymphatic lesion (lymphangioma) typically found in the neck, classically on the left side
Most are evident at birth, around 90% present before 2 years of age
Arise from jugular lymph sac
Transilluminate
can recur after drainage
Branchial Cyst
An oval, mobile cystic mass that develops between the sternocleidomastoid muscle and the pharynx
Develop due to failure of obliteration of the second branchial cleft in embryonic development
Usually present in early adulthood
Cervical Rib
More common in adult females
Around 10% develop thoracic outlet syndrome
Carotid Aneurysm
Pulsatile lateral neck mass which doesn't move on swallowing
Infection
Infectious Mononucleosis (EBV)
HIV
TB