Sandbox: Gertrude
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: , Gertrude Djouka, M.D.[2]
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 | ||||||||||||||
| Thyroglossal duct cyst | ||||||||||||||||
| 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 | Benign | Cat exposure | + | |||||||||||||
| Actinomycosis | Benign | |||||||||||||||
| Mycobacterial infections[1] | Benign | Recent travel to endemic regions
Exposure to TB patients |
- | Matted cervical nodes
Firm Non-tender |
+ | |||||||||||
| Staphylococcal or streptococcal infection | Benign | - | - | + | + | Gram stain: gram (+) cocci in clusters for Staph
Gram (+) cocci in chains for strep Blood Culture: + |
||||||||||
| Parasitic lymphadenopathy | Toxoplasma gondii[2][3] | Benign | 6 years and older adults are more affected in U.S.
Seen in Hot climates |
Cats or birds feces exposure
Drinking unpasteurized milk Undercooked food Organ transplant recipients |
+ | - | Bilateral
Non-tender Symmetrical Non-fluctuant |
- | + | Serology : + IgG and IgM
antibodies |
Follicular hyperplasia | MRI:
Multiple rings enhanced lesions |
Serology
Immunofluorescence MRI CT scan |
|||
| Sarcoidosis[4][5] | Benign | More common in African American women aged 20 - 40 years. | Family history of sarcodosis,
Fatigue, swelling and pain in the joints, |
- | - | Bilateral
tender LAD Swollen, non-tender parotid glands |
Erythema nodosum,
Lupus pernios |
+ | ESR
ACE |
Non-caseating granulomas involved in multiple organs. | CXR: B/L hilar adenopathy
MRI: B/L multiples enlarged cervical lymph nodes |
CT scan of chest
Biopsy MRI |
Heerfordt's syndrome: uveitis, facial nerve paralysis, parotitis | |||
| Amyloidosis | + | Biopsy | ||||||||||||||
| Sjögren syndrome | Benign | Female to male ratio: 9 to 1
May happen at any age Mean age: 40-50 |
History of RA, SLE, and non-hodgkin B-cell lymphoma.
Dry mouth, dry eyes. |
- | + | B/L enlarged parotid glands | Itchy
Rashes Dry |
+ | ESR
Anti-SSA/Ro Anti-SSB/La Cytopenia |
|||||||
| Castleman disease (angiofollicular lymphoproliferative disease) | ||||||||||||||||
| Kikuchi disease (histiocytic necrotizing lymphadenitis) | + | |||||||||||||||
| Kimura disease | ||||||||||||||||
| Rosai-Dorfman disease | ||||||||||||||||
| Kawasaki disease | Benign | Rashes | + | |||||||||||||
| 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
- ↑ Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A (March 2014). "Peripheral lymphadenopathy: approach and diagnostic tools". Iran J Med Sci. 39 (2 Suppl): 158–70. PMC 3993046. PMID 24753638.
- ↑ Kumar GG, Mahadevan A, Guruprasad AS, Kovoor JM, Satishchandra P, Nath A, Ranga U, Shankar SK (June 2010). "Eccentric target sign in cerebral toxoplasmosis: neuropathological correlate to the imaging feature". J Magn Reson Imaging. 31 (6): 1469–72. doi:10.1002/jmri.22192. PMC 2908244. PMID 20512900.
- ↑ [+https://www.cdc.gov/parasites/toxoplasmosis/diagnosis.html "CDC - Toxoplasmosis - Diagnosis"] Check
|url=value (help). - ↑ "Sarcoidosis | National Heart, Lung, and Blood Institute (NHLBI)".
- ↑ Abdel Razek A, Mukherji S (June 2017). "Imaging of sialadenitis". Neuroradiol J. 30 (3): 205–215. doi:10.1177/1971400916682752. PMC 5480791. PMID 28059621. Vancouver style error: initials (help)