Neck Swelling Differential Diagnosis BY Dr. Mohamed Selima

Swellings of the Neck Classification According to site - Those occurring in the midline - Those in the side of the neck According to chronicity - Acute swelling - Chronic swelling

Mid-line Swellings Ludwig Angina Enlarged submental lymph node Sublingual dermoid Lipoma in submental region Thyroglossal cyst Subhyoid bursitis Extrinsic carcinoma of the larynx (late) Goitre (thyroid isthmus / pyramidal lobe) Enlarged lymph node Cystic hygroma (suprasternal space ) Retrosternal goitre Thymic swelling Dermiod cyst ( can occure anywhere in the midline )

Lateral swellings IN THE SUBMANDIBULAR TRIANGLE Enlarged lymph nodes Submandibular salivary gland Deep or plunging ranula Extension of growth from the jaw IN THE CAROTID TRIANGLE Aneurysm of the carotid arteries Carotid body tumours Branchial cyst Bronchogenic carcinoma Goitre Sternmastoid tumour IN THE POSTERIOR TRIANGLE Supraclavicular lymph nodes Cervical rib / cystic hygroma / lipoma / pharyngial pouch Subclavian aneurysm / aberrant thyroid /

Ludwig angina Is a serious, potentially life-threatening cellulitis, or connective tissue infection, of the floor of the mouth, usually occurring in adults with concomitant dental infections and if left untreated, may obstruct the airways, necessitating tracheotomy. Dental infections account for approximately eighty percent of cases of Ludwig's angina It might dangerous complication: - oedema glottis - mediastinitis -fatal septicaemia

Ludwig angina

Branchial CYST Branchial cleft cysts are congenital epithelial cysts, Arise on the lateral part of the neck from failure of obliteration of the second branchial cleft in embryonic development

CERVICAL RIB Is an extra rib which arises from the seventh cervical vertebra. located above the normal first rib. A cervical rib is present in only about 0.2% of population;

LIPOMA Slowly growing tumour encapsulated or diffuse. Soft and slippery

Thyroglossal cyst

Cystic Hygroma Lymphangioma arising under the deep fascia and extending deeply between the muscles. It is translucent

SWELLINGS OF THE LYMPH NODES

SWELLINGS OF THE SUBMANDIBULAR SALIVARY GLAND

Carotid body tumour chemodectoma or ‘potato’ tumour

Sternomastoid tumour Is not a tumour It is the result of birth injury to the sternomastoid muscle, causing thormbosis and subsequent fibrosis. It gives rise to a circumscribed firm mass within muscle,

Aneurysm of the carotid and subclavian A Pulsatile palpable mass in supraclavicular fossa.