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Differential diagnosis of neck masses

Differential diagnosis of neck masses include:

Category Diseases Benign or Malignant Clinical manifestation Paraclinical findings Gold standard diagnosis Associated findings
Demography History Symptoms Signs Lab findings Histopathology Imaging
Pain Dysphagia Mass exam Skin changes LAP Others
Congenital Branchial cleft cyst
  • Benign
  • Age: 1-15 yrs/ varies
  • Familial occurence is noted
- + Sometimes
  • Solitary
  • Smooth
  • Mobile
  • Welldefined
  • Nonpulsatile
  • Fluctuant
  • A skin pit is found at the opening of the cyst
- -
  • Squamous or ciliated epithelial lining
  • Lymphoid tissue with germinal centers and subcapsular sinuses
  • CT: Well defined fluid attenuation with slight enhancement of the capsule
  • Ultrasound: Typical features of a cyst are seen
  • Brachio-oto-renal syndrome
Thyroglossal duct cyst
  • Benign
  • Age: 1-10 yrs
- - -
  • Mass moves upwards with tongue protrusion and swallowing
-
  • Ultrasound: Anechoic, thin walls, and heterogeneous with internal septae
Ultrasonography
Hemangioma
Vascular malformations
Lymphatic malformations
Laryngocele
Ranula
Teratoma
Dermoid cyst
Thymic cyst
Category Diseases Benign or Malignant Demography History Pain Dysphagia Mass exam Skin changes LAP Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Inflammatory Acute sialadenitis
Chronic sialadenitis
Reactive viral lymphadenopathy CMV
EBV
HIV
Viral URI
Bacterial lymphadenopathy Tularemia
Brucellosis
Cat-scratch disease
Actinomycosis
Mycobacterial infections
Staphylococcal or streptococcal infection
Parasitic lymphadenopathy Toxoplasma gondii
Sarcoidosis
Amyloidosis
Sjögren syndrome
Castleman disease (angiofollicular lymphoproliferative disease)
Kikuchi disease (histiocytic necrotizing lymphadenitis)
Kimura disease
Rosai-Dorfman disease
Kawasaki disease
Category Diseases Benign or Malignant Demography History Pain Dysphagia Mass exam Skin changes LAP Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Neoplasm Primary thyroid tumor
Salivary gland neoplasm Pleomorphic adenoma +
Warthin's tumor +
Lymphoepithelioma +
Oncocytoma
Monomorphic adenoma
Mucoepidermoid carcinoma
Adenoid cystic carcinoma
Adenocarcinoma
Salivary duct carcinoma
Squamous cell carcinoma
Parathyroid tumors
Carotid body tumors
Paraganglioma
Schwannoma
Lymphoma
Liposarcoma
Lipoma
Glomus vagale, glomus jugulare tumors
Metastatic head and neck carcinoma
Other Hematoma
Arteriovenous fistula
Goiter
Category Diseases Benign Demography History Pain Dysphagia Mass exam Skin changes LAP Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings

References