Radiological imaging of adult neck masses.

Dr/ ABD ALLAH NAZEER. MD.

Anatomy

Anatomical ConsiderationsProminent LandmarksTriangles of the NeckRegional AnatomyLymph Node LevelsCarotid BulbTransverse Process of C1

Historical Points.Age:

Up to 15yrs (pediatrics) more than 90% benign16 to 40 (young adult) More than 40yrs (older adults) 80% neoplasm 80% of them malignant (secondary>>primary)

Time courseimmunodeficiency

Prior trauma

Travel, Irradiation, Surgery

Associated symptoms fever, dysphagia, weight loss, otalgia,

hearing loss, respiratory difficulties

Perform a FULL head and neck examination

Neck Masses:EpidemiologyAdult neck masses are 90% malignantPediatric neck masses are rarely malignant.Most common neck mass in children is anenlarged reactive lymph node 2ry tobacterial/viral infectionsAlmost 50% of all 2 Y/O children havepalpable normal cervical lymph nodes

Identification of Neck Masses OnBasis Of Their LocationAnterior Neck SwellingsLateral Neck SwellingsPosterior Neck SwellingsDiffuse Neck Swellings

Identification of Neck MassesOn Basis of their location:

Submental (Inframyelohyoid) dermoid.

Lipoma.

Submental lipoma

Thyroglossal duct cyst TGDC.

Submental metastatic lymph nodes with rim enhancement.

Midline Thyrohyoid Region Supraglottic Carcinoma.

Midline Thyrohyoid Region Metastatic PTC

Chondrosarcoma of the Hyoid. Bone.

Midline (Pre-laryngeal/Laryngeal) Thyroid (Pyramidal Lobe PTC).

Midline (Suprasternal & Pretracheal) Jugular Vein Phlebectasia.

PTC metastasis in a Para-tracheal L.N.

Anterior Paramedian Region, laryngeal tumour.

Submandibular Sialadenitis.

Granulomatous Lymphadenitis(Sarcoidosis).

Lymphoma

Submandibular Lipoma.

Plunging Ranula.

CECT (A) shows a low density lesion in the sublingual space (arrow) that extends posterior medial to the SMG(B).

Phlepoectasia (Common facial V)

T.B. Parotitis & Lymphadenitis

Atypical Mycobacterial Cervical Lymphadenitis.

2nd Arch Branchial Cleft Cysts

Branchial Cyst

Metastatic Lymph Nodes at carotid triangle.

B-Cell Lymphoma at carotid triangle.

Sympathetic Schwannoma Neurofibroma

Laryngomucocele

Posterior triangle L.N. enlargement may be due to; TB.

Supraclavicular lymph nodes..

Thank You!