DDx Neck Masses

MM Carr DDS MD MEd

 

Lateral

 

Lymphadenopathy

Infection Mononucleosis

AIDS

Kawasaki disease

Granulomatous Diseases:

 

Tuberculosis

Syphilis

Toxoplasmosis

Actinomycosis

Cat Scratch Fever

Tularemia

Leishmaniasis

Brucellosis

Spread of infection in head

Dental abscess

Tonsillitis

Viral URTI

Tumours

Lymph node metastases

Lymphoma-Hodgkin's/Non-Hodgkin's

Drug effects:

eg: Penicillin, Streptomycin, Sulfonamides, INH, Thiouracil, ASA,

Phenacetin, Meprobamate, Heparin, Typhus antigen, etc.

Sarcoidosis

 

Branchial Cleft Cyst

Laryngocele

Teratoma

Carotid Artery

Aneurysm

Dissection

Carotid Body Tumour

Internal Jugular Vein Aneurysm

Nerves

Neuroma

Schwannoma

Paraganglioma (Sympathetic plexus)

Neuroblastoma

Parotid gland

Parotitis-bacterial or viral (mumps)

Abscess

Benign tumours: Pleomorphic adenoma, Warthin's tumour, Oncocytoma, Hemangioma, Lymphangioma, Lipoma

Malignant tumours: Mucoepidermoid, Adenoid Cystic, Acinic Cell, Adenocarcinoma, SCC

Sjogren's syndrome

Sarcoidosis

Submandibular gland

Sialolithiasis

Sialadenitis

Abscess

Tumour

Muscle

Torticollis

Focal Myositis

Malignant tumour: rhabdomyosarcoma

Other Tumours

Benign:

Lipoma

Fibroma

Hemangioma

 

Midline

 

Thyroid

Goiter

Thyroid nodule

Thyroid cyst

Follicular adenoma

Malignant Tumour:

Papillary, Follicular, Anaplastic, Medullary

Lymphoma

Metastases

Thyroiditis

Thyroid pyramidal lobe

Ectopic thyroid

Parathyroid tumour

Thyroglossal Duct Cyst

Plunging Ranula

Pharyngeal diverticulum

Dermoid cyst

Thymic cyst

Teratoma

 

Diffuse neck swelling

 

Ludwig's angina

Cystic hygroma (Lymphangioma)

Hemangioma 

Diagnostic Pearls

 

90% of pediatric neck masses are inflammatory

90% of adult neck masses are metastatic