Neck mass

Cervical triangle

Med line neck swelling  a-solid  1-submandibular LN enlargement  2-nodule in the isthmus of thyroid gland  b-cystic lesions  1-dermoid cyst  2-thyroglossal cyst  3-cold abscess  4-subhyoid bursitis  5- laryngocele  6-cystadenoma of the thyroid isthmus

Swelling in digastric triangle  1-LN enlargement in submandibular  2-submandibular salivary gland enlargement  How we differentiate both?

Swelling in carotid triangle a-solid  1-upper deep cervical LN enlargement  2-lat thyroid lobe enlargement  2-carotid body tumor b-cystic lesion  1-cold abscess  2-branchial cyst  3-aneurysm of the carotid

Mass of posterior triangle a-solid  1-LN enlargement  2-neurofibroma from brachial plexus  3-cervical rib b-cystic lesion  1-cystic hygroma  2-pharyngeal pouch  3-cold abscess

Dermoid cyst  How it origin  What is it ’ s histology  Type of Dermoid  DD(ectopic thyroid, thyroglossal cyst, LN)

Thyroglossal cyst  Common sites(beneath the foramen cecum, floor of the mouth, above hyoid, beneath the hyoid on thyroid cartilage, at the level of cricoid cartilage  Definition  Clinical features and complications  Recu infections  Abscess and fistula  Papillary carcinoma  Treatment  Thyroglossal fistula

Structures move up with deglutition  1-thyroid mass  2-subhyoid bursitis  3-pretracheal and prelaryngeal LN  4-thyroglossal cyst

Branchial cyst  Origin  Clinical features  1-age=20-25 y  2-swelling  3-cyst lining by squamous  epithelium so contain cheesy,  toothpaste –like material  4-sternomastoid contraction test  5-aspiration of cyst showed cholesterol crystal  6-LNexamination

Cysts which are positive for cholesterol crystals are  1-cystic hygroma  2-thyroglossal cyst  3-hydrocel  4-dental and dentigerous cyst

DD  1-cold abscess  2-cervical Dermoid cyst  3-carotid body tumor  4-submandibular salivary gland swelling  5-Solitary LN enlargement

Cystic hygroma  Definition  Collection of lymphatic sacs which contain clear colorless lymph  Origin  Congenital and consist of a cluster of lymph channels that failed to connected into the normal lymphatic pathway  Sits  1-post triangle  2-axilla  3-groin  4-mediastinum 5-tongue and buccal mucosa

Cold abscess  Causes  1-TB  2-actinomycosis  3-leprosy  Why it is called cold abscess

Pathology Stage of inflammation  1-lymphadenitis  2-periadenitis  3-cold abscess

Carotid body tumor(chomodectoma, potato tumor)  1-Originate at carotid body at bifurcation of carotid  2-age ys  3-slow growing take ys  4-occasionally press on the carotid sinus produces attack of faintness

DD  1-LN  2-sternomastoid tumor  3-branchial cyst  4-aneurysm of carotid

Sternomastoid tumor  1-3-4wks of childhood  2-hard smooth non-tender mass adherent to muscle  3-Head point toward the same affected muscle and chin to opposite side (torticollis)  4-Delay in correction may produce facial deformity