Common Causes of Neck Lumps
Definition | Lymphadenopathy | Thyroid Nodules | Salivary Gland Swelling | Congenital Cysts | Lipoma | Sebaceous Cyst | References
Definition
Neck lumps are abnormal masses or swellings that can develop in the neck. They can vary in size and consistency and may have various causes, ranging from benign to malignant conditions.
Lymphadenopathy
Definition: Lymphadenopathy refers to the enlargement of lymph nodes, which can be due to infection, inflammation, or malignancy.
Aetiology: Infections (e.g., bacterial, viral), autoimmune diseases (e.g., rheumatoid arthritis), malignancies (e.g., lymphoma, metastatic cancer).
Pathophysiology: Lymph nodes enlarge in response to antigenic stimulation from infections, inflammatory conditions, or malignant cells.
Risk Factors: Recent infection, chronic inflammatory conditions, exposure to carcinogens, immunocompromised state.
Signs and Symptoms: Swollen, tender lymph nodes, fever, night sweats, weight loss (in malignancies).
Investigations: Clinical examination, blood tests (e.g., FBC, ESR, CRP), imaging (e.g., ultrasound, CT), biopsy if malignancy is suspected.
Management:
- Antibiotics for bacterial infections
- Management of underlying inflammatory conditions
- Referral to oncology for suspected malignancy
- Regular monitoring and follow-up
Thyroid Nodules
Definition: Thyroid nodules are lumps within the thyroid gland that can be benign or malignant.
Aetiology: Benign conditions (e.g., multinodular goitre, thyroid cysts), malignancies (e.g., thyroid cancer).
Pathophysiology: Nodules develop due to overgrowth of thyroid tissue, cyst formation, or malignant transformation.
Risk Factors: Female gender, radiation exposure, family history of thyroid disease, iodine deficiency.
Signs and Symptoms: Palpable lump in the neck, difficulty swallowing, hoarseness, symptoms of hyperthyroidism or hypothyroidism.
Investigations: Thyroid function tests, ultrasound, fine-needle aspiration biopsy (FNAB), thyroid scintigraphy.
Management:
- Monitoring for benign nodules
- Thyroid hormone suppression therapy
- Surgery for malignant or symptomatic nodules
- Radioactive iodine therapy for certain types of thyroid cancer
Salivary Gland Swelling
Definition: Swelling of the salivary glands, which can be due to infection, inflammation, or tumours.
Aetiology: Infections (e.g., mumps, bacterial sialadenitis), sialolithiasis (salivary stones), tumours (benign or malignant).
Pathophysiology: Infections or blockages cause inflammation and swelling, while tumours can arise from the glandular tissue.
Risk Factors: Dehydration, poor oral hygiene, smoking, radiation exposure.
Signs and Symptoms: Swollen, painful gland, dry mouth, fever, difficulty swallowing, palpable mass.
Investigations: Clinical examination, ultrasound, sialography, fine-needle aspiration biopsy (FNAB), MRI/CT for tumours.
Management:
- Antibiotics for bacterial infections
- Hydration and massage for sialolithiasis
- Surgery for persistent stones or tumours
- Regular monitoring and follow-up
Congenital Cysts
Definition: Congenital cysts are developmental anomalies that present as cystic masses in the neck, such as thyroglossal duct cysts or branchial cleft cysts.
Aetiology: Developmental remnants that fail to regress during embryonic development.
Pathophysiology: Cysts form from remnants of embryological structures such as the thyroglossal duct or branchial apparatus.
Risk Factors: Congenital, present from birth.
Signs and Symptoms: Painless, fluctuant mass in the neck, may become infected and present with pain and redness.
Investigations: Ultrasound, MRI/CT for detailed assessment, fine-needle aspiration biopsy (FNAB) if infected.
Management:
- Surgical excision
- Antibiotics for infected cysts
- Regular monitoring for recurrence
Lipoma
Definition: A lipoma is a benign tumour composed of adipose tissue, presenting as a soft, movable lump under the skin.
Aetiology: Overgrowth of fat cells.
Pathophysiology: Benign proliferation of mature fat cells.
Risk Factors: Middle age, family history of lipomas.
Signs and Symptoms: Soft, painless, movable lump under the skin.
Investigations: Clinical examination, ultrasound to confirm diagnosis.
Management:
- Observation if asymptomatic
- Surgical excision if symptomatic or for cosmetic reasons
Sebaceous Cyst
Definition: A sebaceous cyst is a benign cyst arising from sebaceous glands, containing keratin and sebum.
Aetiology: Blockage of sebaceous gland ducts.
Pathophysiology: Accumulation of sebum and keratin within a cystic cavity.
Risk Factors: Oily skin, history of acne, trauma to sebaceous glands.
Signs and Symptoms: Small, round, painless lump under the skin, may become infected and painful.
Investigations: Clinical examination, ultrasound if necessary.
Management:
- Observation if asymptomatic
- Incision and drainage if infected
- Surgical excision if recurrent or symptomatic
References
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