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.