Sunday, October 16, 2011

Differential Diagnosis of Head and Neck Swellings and it’s management


Head and Neck – Complex region

 Numerous Lymph nodes are located in the Head &  Neck region
 Salivary glands
 Thyroid gland, Parathyroid glands, Thymus gland etc.,
Causes Head and Neck Swellings
  1. Cysts, thyroid masses, vascular masses, salivary gland masses e.t.c, can cause swellings in the head and neck.
  2. Enlargement of lymph nodes in the head and neck can also cause a swelling.
  3. Inflammatory / Infectious conditions can also cause lumps of the head and neck region.
  4. Benign & Malignant masses can cause swelling of the head and neck.


Enlargement of lymph nodes
  • This is the most common cause of new neck swellings.
  • Lymph nodes, which are part of the immune system, can enlarge when the body rallies to fight an infection.
  • When the infection recedes, lymph swelling subsides as well.
lymph nodes
Benign Swellings of the Head and Neck
Benign Swellings / masses do not spread (metastasize) to surrounding tissue and are not cancerous.
 Nevertheless, benign masses can be serious if they impact nerves or exert pressure in the head and neck, and are therefore often removed surgically.
These include cysts, thyroid masses, vascular masses, salivary gland masses, and others.
Congenital/ Developmental Cysts
     (i) Thyroglossal cyst
Thyroglossal cyst
    (ii) Branchial cyst
Branchial cyst
    (iii) Sebaceous cyst
    (iv) Dermoid cyst
Inflammatory Lumps of the Head and Neck
  • Chronic inflammatory disease like Tuberculosis, Sarcoidosis, Cat Scratch disease.
  • These disease processes have to be treated medically. For example, Patients with tuberculous lymphadenitis should undergo anti-tuberculosis drug therapy.

Neoplastic Masses of the Head and Neck
     Benign Head and Neck Masses
  • Any structure of the head and neck may be involved.
  • Skin, SC Tissue, fat, nerve muscle, blood vessel can be affected.
  • For example, Lipoma (Fat), Fibroma (Fibrous tissue), Hemangioma( Blood vessel), Neuroma (Nerve).
  • Benign tumors of the Salivary gland like Pleomorphic adenoma, Warthins tumour etc., can present with a significant head and neck swelling.
  • Multinodular goitre, cyst, adenoma can affect the Thyroid glands.

     Malignant Masses of the Head and Neck
  •   Malignant masses can occur anywhere in the upper aero-digestive tract.
  •  May also arise from skin and soft and hard tissues of head and neck-SCC, melanoma
  •   It can occur from the salivary glands, thyroid gland, parathyroid gland.


Download the PPT Lecture Note

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