1. Neck Swelling Differential DiagnosisBY
Dr. Mohamed Selima

2. 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

3. 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 )

4. 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 /

5. 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

6. Ludwig angina

7. 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

8. 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;

9. LIPOMA Slowly growing tumour encapsulated or diffuse.
Soft and slippery

10. Thyroglossal cyst

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

12. SWELLINGS OF THE LYMPH NODES

13. SWELLINGS OF THE SUBMANDIBULAR SALIVARY GLAND

14. Carotid body tumour chemodectoma or ‘potato’ tumour

15. 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,

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