Lumps in the Neck(கழுத்தில் ஏற்படும் கட்டிகள் ,நுரையீரல் நீர்க்கட்டி,தைராய்டு நீர்க்கட்டி &சுரப்பிகளுக்கான சிகிச்சை முறைகள் )
Lumps in the neck
Do not biopsy these lumps unless tumours within the head and neck have been excluded by an ENT surgeon. Culture all biopsied nodes for TB (do not put in formalin).
Categorization of causes of lumps in the neck
Skin lumps Arterial lump Glands
Sebaceous cysts Carotid aneurysm Thyroid
Lipomas Carotid body Salivary
Dermoid cysts Haemangiomas
Lymph nodes Abscesses Embryonic lumps
Tuberculosis TB (collar-stud abscess) Thyroglossal cysts
Actinomycosis Retropharyngeal (abscess) Branchial cyst
Rubella, EBV, etc. Cystic hygroma
Malignancy
Carotid body tumours (chemodectoma)
This is a slow-growing tumour which splays out the carotid bifurcation. It is usually firm, occasionally it is soft and pulsatile. They do not usually cause bruits. They may be bilateral, familial, and malignant (5%). This tumour should be suspected in lumps just anterior to the upper third of sternomastoid.
Treatment : Extirpation by a vascular surgeon.
Branchial cyst
These owe their origin to the failure of the cervical sinus to close during development due to an overgrowth of the second branchial arch. It presents as a 'half-filled hotwater bottle' just anterior to sternomastoid. The fluid contains cholestrol crystals.
Treatment : excision
Benign mixed salivary tumours (pleomorphic adenoma)
Usually involves the parotid. It presents as a slowly growing non-tender mass. The differential diagnosis includes salivary stones (sialadentis) in which the gland usually fluctuates. Excision is the treatment of choice.
Other salivary gland tumours Adenolymphomas, adenocystic carcinomas os submandibular glands(cylindroma), many others.
Cystic hygroma
Malformation and/or neoplasia of lymph vessles. They transilluminate. Treat by excision.
Benign mixed salivary tumours (pleomorphic adenoma)
Usually involves the parotid. It presents as a slowly growing non-tender mass. The differential diagnosis includes salivary stones (sialadentis) in which the gland usually fluctuates. Excision is the treatment of choice.
Other salivary gland tumours Adenolymphomas, adenocystic carcinomas os submandibular glands(cylindroma), many others.
Cystic hygroma
Malformation and/or neoplasia of lymph vessles. They transilluminate. Treat by excision.
