Neck masses differential diagnosis: Difference between revisions

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[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Neck_masses]]
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Neck_masses]]


{{CMG}}
{{CMG}}; {{AE}} {{M.N}}, {{G.D.}}, {{Qurrat}}


==Overview==
==Overview==
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*[[Incidence]]: 1 in 2000 to 5000 births
*[[Incidence]]: 1 in 2000 to 5000 births
*Sex: No predilection
*Gender: No predilection
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*[[Venous]]: Present with a bluish [[swelling]]
*[[Venous]]: Present with a bluish [[swelling]]
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*[[Age]]: Birth-5 years old
*[[Age]]: Birth-5 years old
*Sex: No predilection
*Gender: No predilection
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*Presents with a large [[swelling]] mainly in the [[neck]]
*Presents with a large [[swelling]] mainly in the [[neck]]
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*[[Incidence]]: 1:4000 births
*[[Incidence]]: 1:4000 births
*Sex: No predilection
*Gender: No predilection
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*Presents as a firm [[lateral]] neck mass
*Presents as a firm [[lateral]] neck mass
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*[[Age]]: Occurs in all age groups
*[[Age]]: Occurs in all age groups
*Sex: No predilection
*Gender: No predilection
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*Presents with an unilateral [[erythematous]] [[swelling]]
*Presents with an unilateral [[erythematous]] [[swelling]]
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*[[Age]]: Occurs in all age groups
*[[Age]]: Occurs in all age groups
*Sex: No predilection
*Gender: No predilection
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*Presents with an unilateral [[swelling]]
*Presents with an unilateral [[swelling]]
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*[[Age]]: 10-35 years old
*[[Age]]: 10-35 years old
*Sex: No predilection
*Gender: No predilection
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*[[Flu]]-like illness
*[[Flu]]-like illness
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*[[Age]]: Mainly adolescents
*[[Age]]: Mainly adolescents
*Sex: No predilection
*Gender: No predilection
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*[[Sore throat]]
*[[Sore throat]]
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*[[Prevalence]]: 1.1 million in U.S
*[[Prevalence]]: 1.1 million in U.S
*Sex: [[Males]]>[[females]]
*Gender: [[Males]]>[[females]]
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*[[Flu]]-like illness
*[[Flu]]-like illness
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*[[Age]]: Affects all age groups
*[[Age]]: Affects all age groups
*Sex: No predilection
*Gender: No predilection
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*[[Fever]]
*[[Fever]]
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*[[Incidence]]: 100-200 cases anually in USA
*[[Incidence]]: 100-200 cases anually in USA
*Sex: [[Males]]>[[females]]
*Gender: [[Males]]>[[females]]
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*[[Flu]]-like illness
*[[Flu]]-like illness
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**Mass is hyperintense on T2
**Mass is hyperintense on T2
**Enhancement on contrast
**Enhancement on contrast
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* [[Biopsy|Incisional biopsy]] and [[histopathological]] examination
* [[Biopsy|Incisional biopsy]] and [[histopathological]] examination
| align="center" style="background:#F5F5F5;" |-
| align="center" style="background:#F5F5F5;" |-
|-
|-
! align="left" style="background:#DCDCDC;" |[[Monomorphic adenoma]] <ref name="pmid10889498">{{cite journal |vauthors=Kim KH, Sung MW, Kim JW, Koo JW |title=Pleomorphic adenoma of the trachea |journal=Otolaryngol Head Neck Surg |volume=123 |issue=1 Pt 1 |pages=147–8 |date=July 2000 |pmid=10889498 |doi=10.1067/mhn.2000.102809 |url=}}</ref><ref name="pmid24431845">{{cite journal |vauthors=Pramod Krishna B |title=Pleomorphic Adenoma of Minor Salivary Gland in a 14 year Old Child |journal=J Maxillofac Oral Surg |volume=12 |issue=2 |pages=228–31 |date=June 2013 |pmid=24431845 |pmc=3681990 |doi=10.1007/s12663-010-0125-5 |url=}}</ref><ref name="pmid30546932">{{cite journal |vauthors=Kessler AT, Bhatt AA |title=Review of the Major and Minor Salivary Glands, Part 2: Neoplasms and Tumor-like Lesions |journal=J Clin Imaging Sci |volume=8 |issue= |pages=48 |date=2018 |pmid=30546932 |pmc=6251244 |doi=10.4103/jcis.JCIS_46_18 |url=}}</ref>
! align="center" style="background:#DCDCDC;" |[[Monomorphic adenoma]] <ref name="pmid10889498">{{cite journal |vauthors=Kim KH, Sung MW, Kim JW, Koo JW |title=Pleomorphic adenoma of the trachea |journal=Otolaryngol Head Neck Surg |volume=123 |issue=1 Pt 1 |pages=147–8 |date=July 2000 |pmid=10889498 |doi=10.1067/mhn.2000.102809 |url=}}</ref><ref name="pmid24431845">{{cite journal |vauthors=Pramod Krishna B |title=Pleomorphic Adenoma of Minor Salivary Gland in a 14 year Old Child |journal=J Maxillofac Oral Surg |volume=12 |issue=2 |pages=228–31 |date=June 2013 |pmid=24431845 |pmc=3681990 |doi=10.1007/s12663-010-0125-5 |url=}}</ref><ref name="pmid30546932">{{cite journal |vauthors=Kessler AT, Bhatt AA |title=Review of the Major and Minor Salivary Glands, Part 2: Neoplasms and Tumor-like Lesions |journal=J Clin Imaging Sci |volume=8 |issue= |pages=48 |date=2018 |pmid=30546932 |pmc=6251244 |doi=10.4103/jcis.JCIS_46_18 |url=}}</ref>
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* [[Benign]] or [[malignant]]
* [[Benign]] or [[malignant]]
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*Age: From 26 to 76 years
*Age: 26-76 years
*Rare in children
*Rare in children
*Sex: No sex predilection
*Gender: No predilection
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*Growing [[palpable]] painless [[mass]] on jaw or in [[oral cavity]]
*Growing [[palpable]] painless [[mass]] on jaw or in [[oral cavity]]
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*[[Lymphadenopathy]] (if transformed to [[malignant]])
*[[Lymphadenopathy]] (if transformed to [[malignant]])
*[[Ulceration|Pain and ulceration]] (in later stage)
*[[Ulceration|Pain and ulceration]] (in later stage)
*
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* [[Nodular]]
* [[Nodular]]
* Fluctuant [[swelling]]
* Fluctuant [[swelling]]
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*Normal
*Normal
*Redness
*Redness
*Skin [[ulceration]]
*Skin [[ulceration]]
*May have lymphadenopathy
*May have [[lymphadenopathy]]
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* Normal
* Normal
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*Straw colored fluid on [[aspiration]]
*Straw colored fluid on [[aspiration]]
*
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* [[Ultrasound]]:
* [[Ultrasound]]:
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**May show cystic an solid components
**May show cystic an solid components
* [[Computed tomography|CT:]]
* [[Computed tomography|CT:]]
**useful for [[lesions]] with [[calcification]] and venous pleboliths
**useful for [[lesions]] with [[calcification]] and venous phleboliths
* [[Magnetic resonance imaging|MRI:]]
* [[Magnetic resonance imaging|MRI:]]
**Test of choice
**Test of choice
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* [[Biopsy|Incisional biopsy]] and [[Histopathological|histopathological examination]]
* [[Biopsy|Incisional biopsy]] and [[Histopathological|histopathological examination]]
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|-
|-
! align="center" style="background:#DCDCDC;" |[[Mucoepidermoid carcinoma]]
! align="center" style="background:#DCDCDC;" |[[Mucoepidermoid carcinoma]]
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* [[Malignant]]
* [[Malignant]]
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*Age:Mean age of 59
*Age: Mean age of 59
*Female predilection
*Female predilection
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* [[Cystic]] and [[Mass|solid mass]]
* [[Cystic]] and [[Mass|solid mass]]
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* May have lymphadenopathy
* May have [[lymphadenopathy]]
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* [[Gross examination|Gross findings]]:
* [[Gross examination|Gross findings]]:
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|-
|-
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Neoplasm
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Neoplasm
! rowspan="4" align="left" style="background:#DCDCDC;" |[[Salivary gland neoplasm]]
! rowspan="4" align="center" style="background:#DCDCDC;" |[[Salivary gland neoplasm]]
! align="left" style="background:#DCDCDC;" |[[Adenoid cystic cancer|Adenoid cystic carcinoma]] <ref name="pmid17825603">{{cite journal |vauthors=Jones AV, Craig GT, Speight PM, Franklin CD |title=The range and demographics of salivary gland tumours diagnosed in a UK population |journal=Oral Oncol. |volume=44 |issue=4 |pages=407–17 |date=April 2008 |pmid=17825603 |doi=10.1016/j.oraloncology.2007.05.010 |url=}}</ref>
! align="center" style="background:#DCDCDC;" |[[Adenoid cystic cancer|Adenoid cystic carcinoma]] <ref name="pmid17825603">{{cite journal |vauthors=Jones AV, Craig GT, Speight PM, Franklin CD |title=The range and demographics of salivary gland tumours diagnosed in a UK population |journal=Oral Oncol. |volume=44 |issue=4 |pages=407–17 |date=April 2008 |pmid=17825603 |doi=10.1016/j.oraloncology.2007.05.010 |url=}}</ref>
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* [[Malignant]]
* [[Malignant]]
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* Age: 40s to 60s
* Age: 40s-60s
* Gender: Female predominance
* Gender: Female predominance
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* Slow growing rare tumor with low [[Recurrence plot|recurrence]]
* Slow growing rare tumor with low [[Recurrence plot|recurrence]]
| align="center" style="background:#F5F5F5;" | ±
| align="center" style="background:#F5F5F5;" | ±
| align="center" style="background:#F5F5F5;" | ±
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* Solid [[mass]]
* Solid [[mass]]
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* Normal to [[Ulcerated lesion|ulcerated lesions]]
* Normal to [[Ulcerated lesion|ulcerated lesions]]
* May have lymphadenopathy
* May have [[lymphadenopathy]]
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* [[Gross]] findings:  
* [[Gross]] findings:  
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* [[Microscopic]] findings:  
* [[Microscopic]] findings:  
** Components of large cells with [[Pleomorphic|pleomorphic nuclei]]
** Components of large cells with [[Pleomorphic|pleomorphic nuclei]]
** Increased mitotic activity
** Increased [[mitotic]] activity
** Focal [[Necrosis|necrosis.]]
** Focal [[Necrosis|necrosis]]
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* [[Imaging]] reveal dimensions of the [[tumor]], local spread and [[Metastasis|distant metastasis]]
* [[Imaging]] reveal dimensions of the [[tumor]], local spread, and [[Metastasis|distant metastasis]]
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* [[Biopsy]] and [[Histopathological|histopathological examination]]
* [[Biopsy]] and [[Histopathological|histopathological examination]]
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|-
|-
! align="left" style="background:#DCDCDC;" |[[Adenocarcinoma]]
! align="center" style="background:#DCDCDC;" |[[Adenocarcinoma]]
<ref name="pmid16487803">{{cite journal |vauthors=Beltran D, Faquin WC, Gallagher G, August M |title=Selective immunohistochemical comparison of polymorphous low-grade adenocarcinoma and adenoid cystic carcinoma |journal=J. Oral Maxillofac. Surg. |volume=64 |issue=3 |pages=415–23 |date=March 2006 |pmid=16487803 |doi=10.1016/j.joms.2005.11.027 |url=}}</ref>
<ref name="pmid16487803">{{cite journal |vauthors=Beltran D, Faquin WC, Gallagher G, August M |title=Selective immunohistochemical comparison of polymorphous low-grade adenocarcinoma and adenoid cystic carcinoma |journal=J. Oral Maxillofac. Surg. |volume=64 |issue=3 |pages=415–23 |date=March 2006 |pmid=16487803 |doi=10.1016/j.joms.2005.11.027 |url=}}</ref>
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* Its a [[tumor]] of minor [[salivary glands]]
* Its a [[tumor]] of minor [[salivary glands]]
* May present as small [[ulceration]] or nodules in [[oral cavity]]
* May present as small [[ulceration]] or [[nodules]] in [[oral cavity]]
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" | −
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* Normal to [[Ulcerated lesion|ulcerated lesions]]
* Normal to [[Ulcerated lesion|ulcerated lesions]]
* May have lymphadenopathy
* May have [[lymphadenopathy]]
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* May be normal  
* May be normal  
* Or may show [[anemia]] and blood cell disorders with distant bone [[invasion]]
* Or may show [[anemia]] and [[blood cell]] disorders with distant bone [[invasion]]
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* On [[histology]] it is confused with Adeocyctic [[carcinoma]]  
* On [[histology]] it is confused with Adeocyctic [[carcinoma]]  
* With components of gland and cyst formations.
* Components of [[gland]] and [[cyst]] formations
* It has more perineural [[invasion]].
* More perineural [[invasion]]
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* [[CT]] and [[MRI]]   
* [[CT]] and [[MRI]]   
* [[MRI]] being more accurate for adjacent tissue involvement and [[lymphadenopathy]].
* [[MRI]] being more accurate for adjacent [[tissue]] involvement and [[lymphadenopathy]]
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| align="left" style="background:#F5F5F5;" |
* [[Biopsy]] and [[histopathological]] examination
* [[Biopsy]] and [[histopathological]] examination
| align="center" style="background:#F5F5F5;" |−
| align="center" style="background:#F5F5F5;" |−
|-
|-
! align="left" style="background:#DCDCDC;" |[[Salivary gland cancer|Salivary duct cancer]]
! align="center" style="background:#DCDCDC;" |[[Salivary gland cancer|Salivary duct cancer]]<ref name="pmid22434951">{{cite journal |vauthors=Mlika M, Kourda N, Zidi Y, Aloui R, Zneidi N, Rammeh S, Zermani R, Jilani SB |title=Salivary duct carcinoma of the parotid gland |journal=J Oral Maxillofac Pathol |volume=16 |issue=1 |pages=134–6 |date=January 2012 |pmid=22434951 |pmc=3303509 |doi=10.4103/0973-029X.92992 |url=}}</ref><ref name="pmid29103750">{{cite journal |vauthors=Schmitt NC, Kang H, Sharma A |title=Salivary duct carcinoma: An aggressive salivary gland malignancy with opportunities for targeted therapy |journal=Oral Oncol. |volume=74 |issue= |pages=40–48 |date=November 2017 |pmid=29103750 |pmc=5685667 |doi=10.1016/j.oraloncology.2017.09.008 |url=}}</ref><ref name="pmid23821208">{{cite journal |vauthors=Simpson RH |title=Salivary duct carcinoma: new developments--morphological variants including pure in situ high grade lesions; proposed molecular classification |journal=Head Neck Pathol |volume=7 Suppl 1 |issue= |pages=S48–58 |date=July 2013 |pmid=23821208 |pmc=3712088 |doi=10.1007/s12105-013-0456-x |url=}}</ref>
<ref name="pmid22434951">{{cite journal |vauthors=Mlika M, Kourda N, Zidi Y, Aloui R, Zneidi N, Rammeh S, Zermani R, Jilani SB |title=Salivary duct carcinoma of the parotid gland |journal=J Oral Maxillofac Pathol |volume=16 |issue=1 |pages=134–6 |date=January 2012 |pmid=22434951 |pmc=3303509 |doi=10.4103/0973-029X.92992 |url=}}</ref><ref name="pmid29103750">{{cite journal |vauthors=Schmitt NC, Kang H, Sharma A |title=Salivary duct carcinoma: An aggressive salivary gland malignancy with opportunities for targeted therapy |journal=Oral Oncol. |volume=74 |issue= |pages=40–48 |date=November 2017 |pmid=29103750 |pmc=5685667 |doi=10.1016/j.oraloncology.2017.09.008 |url=}}</ref><ref name="pmid23821208">{{cite journal |vauthors=Simpson RH |title=Salivary duct carcinoma: new developments--morphological variants including pure in situ high grade lesions; proposed molecular classification |journal=Head Neck Pathol |volume=7 Suppl 1 |issue= |pages=S48–58 |date=July 2013 |pmid=23821208 |pmc=3712088 |doi=10.1007/s12105-013-0456-x |url=}}</ref>
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* [[Malignant]]
* [[Malignant]]
(Highly aggressive)
(Highly aggressive)
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* [[Incidence]]: 1% to 3%
* [[Incidence]]: 1-3%
* Gender: Men
* Gender: Male predilection
* Mean age: 55 to 61 years
* Mean age: 55-61 years old
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* Rapidly growing [[mass]] with jaw involvement
* Rapidly growing [[mass]] with jaw involvement
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*Hard
*Hard
*Non-compressible [[mass]]
*Non-compressible [[mass]]
*May present with:
**Facial paralysis in case of facial nerve involvement
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* Ulceration of [[mucosa]] and [[Ulceration|skin]]
* Ulceration of [[mucosa]] and [[Ulceration|skin]]
* May have lymphadenopathy
* May have [[lymphadenopathy]]
* [[facial paralysis]] in case of [[facial nerve]] involvement
* [[facial paralysis]] in case of [[facial nerve]] involvement
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* [[Pathology|Patho]]<nowiki/>morphologically [[tumor]] of [[Salivary gland|salivary ducts]] resembles tumor of [[breast]] ducts
* Pathomorphologically [[tumor]] of [[Salivary gland|salivary ducts]] resembles tumor of [[breast]] ducts
* That <nowiki/>is where it name is derived fro<nowiki/>m
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* [[Gross examination|Gross]] findings:
* [[Gross examination|Gross]] findings:
**Firm [[mass]]
**Firm [[mass]]
**[[Cystic|Cystic component]] of variable size and<nowiki/> dimension
**[[Cystic|Cystic component]] of variable size and dimension
*[[Microscopic|Microscopic finding]]<nowiki/>s:
*[[Microscopic|Microscopic finding]]:
**[[Microscopic|Microscopica]]<nowiki/>[[Microscopic|lly]] it resembles ductal c<nowiki/>arcinoma of [[breast]]Intraductal components invading surrounding tissues
**Resembling ductal carcinoma of [[breast]]
*Intra-ductal component of [[tumor]] arran<nowiki/>ged in several forms:  
**Intraductal components invading surrounding tissue in several forms:  
**cribriform
***cribriform
**[[papillary]]
***[[papillary]]
**Solid with<nowiki/> comedo-like c<nowiki/>entral [[necrosis|necros]]<nowiki/>[[necrosis|is]]
***Solid with comedo-like central [[necrosis]]
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* Non-specific features on [[Computed tomography|CT]] and [[MRI]]
* Non-specific features on [[Computed tomography|CT]] and [[MRI]]
* Shows neural and [[jaw]] involvement.
* Shows [[neural]] and [[jaw]] involvement
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* [[Biopsy]] and [[histopathological]] examination
* [[Biopsy]] and [[histopathological]] examination
| align="center" style="background:#F5F5F5;" |−
| align="center" style="background:#F5F5F5;" |−
|-
|-
! align="center" style="background:#DCDCDC;" |[[Squamous cell carcinoma]]
! align="center" style="background:#DCDCDC;" |[[Squamous cell carcinoma]]<ref name="pmid25328317">{{cite journal |vauthors=Manvikar V, Ramulu S, Ravishanker ST, Chakravarthy C |title=Squamous cell carcinoma of submandibular salivary gland: A rare case report |journal=J Oral Maxillofac Pathol |volume=18 |issue=2 |pages=299–302 |date=May 2014 |pmid=25328317 |pmc=4196305 |doi=10.4103/0973-029X.140909 |url=}}</ref><ref name="pmid16475198">{{cite journal |vauthors=Ying YL, Johnson JT, Myers EN |title=Squamous cell carcinoma of the parotid gland |journal=Head Neck |volume=28 |issue=7 |pages=626–32 |date=July 2006 |pmid=16475198 |doi=10.1002/hed.20360 |url=}}</ref>
<ref name="pmid25328317">{{cite journal |vauthors=Manvikar V, Ramulu S, Ravishanker ST, Chakravarthy C |title=Squamous cell carcinoma of submandibular salivary gland: A rare case report |journal=J Oral Maxillofac Pathol |volume=18 |issue=2 |pages=299–302 |date=May 2014 |pmid=25328317 |pmc=4196305 |doi=10.4103/0973-029X.140909 |url=}}</ref><ref name="pmid16475198">{{cite journal |vauthors=Ying YL, Johnson JT, Myers EN |title=Squamous cell carcinoma of the parotid gland |journal=Head Neck |volume=28 |issue=7 |pages=626–32 |date=July 2006 |pmid=16475198 |doi=10.1002/hed.20360 |url=}}</ref>
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Malignant]]
* [[Malignant]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Incidence: rare [[tumor]]
* Incidence: rare
* Age: Old age , 61 to 68 years
* Age: Old age , 61-68 years
* Male predilection
* Male predilection
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
Line 1,344: Line 1,337:
* Thinning and discoloration of [[skin]]
* Thinning and discoloration of [[skin]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Past radiation exposure is a strong [[risk factor]]
* Past [[radiation]] exposure is a strong [[risk factor]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Gross]] findings: Skin tissue and thinning of [[skin]]
* [[Gross]] findings: Thinning of [[skin]]
* [[Microscopically]] findings:
* [[Microscopically]] findings: Nest and solid sheets of [[Tumor cell|tumor cells]] arranged in [[glandular]] pattern
Nest and solid sheets of [[Tumor cell|tumor cells]] arranged in [[glandular]] pattern.
* [[Immunohistochemical staining]] can be used to mark the [[squamous]] and [[keratin]] component
* [[Immunohistochemical staining]] can be used to mark the [[squamous]] and [[keratin]] component.
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Tumor]] dimension can be delineated using both [[CT]] and [[MRI]]
* [[Tumor]] dimension can be delineated using both [[CT]] and [[MRI]]
| align="center" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Biopsy]] and [[histopathological]] examination
* [[Biopsy]] and [[histopathological]] examination
| align="center" style="background:#F5F5F5;" |−
| align="center" style="background:#F5F5F5;" |−
Line 1,373: Line 1,365:
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Neoplasm
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Neoplasm
! colspan="2" align="center" style="background:#DCDCDC;" |[[Hypopharyngeal cancer]]<ref name="pmid12560383">{{cite journal |vauthors=Helliwell TR |title=acp Best Practice No 169. Evidence based pathology: squamous carcinoma of the hypopharynx |journal=J. Clin. Pathol. |volume=56 |issue=2 |pages=81–5 |date=February 2003 |pmid=12560383 |pmc=1769882 |doi= |url=}}</ref><ref>{{cite journal|journal=International Journal of Recent Scientific Research|issn=09763031|doi=10.24327/IJRSR}}</ref><ref name="Maaslandvan den Brandt2014">{{cite journal|last1=Maasland|first1=Denise HE|last2=van den Brandt|first2=Piet A|last3=Kremer|first3=Bernd|last4=Goldbohm|first4=R Alexandra|last5=Schouten|first5=Leo J|title=Alcohol consumption, cigarette smoking and the risk of subtypes of head-neck cancer: results from the Netherlands Cohort Study|journal=BMC Cancer|volume=14|issue=1|year=2014|issn=1471-2407|doi=10.1186/1471-2407-14-187}}</ref>
! colspan="2" align="center" style="background:#DCDCDC;" |[[Hypopharyngeal cancer]]<ref name="pmid12560383">{{cite journal |vauthors=Helliwell TR |title=acp Best Practice No 169. Evidence based pathology: squamous carcinoma of the hypopharynx |journal=J. Clin. Pathol. |volume=56 |issue=2 |pages=81–5 |date=February 2003 |pmid=12560383 |pmc=1769882 |doi= |url=}}</ref><ref>{{cite journal|journal=International Journal of Recent Scientific Research|issn=09763031|doi=10.24327/IJRSR}}</ref><ref name="Maaslandvan den Brandt2014">{{cite journal|last1=Maasland|first1=Denise HE|last2=van den Brandt|first2=Piet A|last3=Kremer|first3=Bernd|last4=Goldbohm|first4=R Alexandra|last5=Schouten|first5=Leo J|title=Alcohol consumption, cigarette smoking and the risk of subtypes of head-neck cancer: results from the Netherlands Cohort Study|journal=BMC Cancer|volume=14|issue=1|year=2014|issn=1471-2407|doi=10.1186/1471-2407-14-187}}</ref>
| align="center" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Malignant]]
* [[Malignant]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
Line 1,379: Line 1,371:
* [[Age]]: 55-65 years old
* [[Age]]: 55-65 years old
* [[Incidence]]: < 1/100,000 in U.S.
* [[Incidence]]: < 1/100,000 in U.S.
* More common: Japan, India, Iran
* More common in Japan, India, Iran
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Tobacco]] use
* [[Tobacco]] use
Line 1,410: Line 1,402:
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" | −
|-
|-
! colspan="2" align="center" style="background:#DCDCDC;" |[[Parathyroid cancer]]
! colspan="2" align="center" style="background:#DCDCDC;" |[[Parathyroid cancer]]<ref name="pmid22327883">{{cite journal |vauthors=Wei CH, Harari A |title=Parathyroid carcinoma: update and guidelines for management |journal=Curr Treat Options Oncol |volume=13 |issue=1 |pages=11–23 |date=March 2012 |pmid=22327883 |doi=10.1007/s11864-011-0171-3 |url=}}</ref><ref name="pmid17713315">{{cite journal |vauthors=Sahasranam P, Tran MT, Mohamed H, Friedman TC |title=Multiglandular parathyroid carcinoma: a case report and brief review |journal=South. Med. J. |volume=100 |issue=8 |pages=841–4 |date=August 2007 |pmid=17713315 |doi=10.1097/SMJ.0b013e318073ca37 |url=}}</ref><ref name="pmid4886854">{{cite journal |vauthors=Holmes EC, Morton DL, Ketcham AS |title=Parathyroid carcinoma: a collective review |journal=Ann. Surg. |volume=169 |issue=4 |pages=631–40 |date=April 1969 |pmid=4886854 |pmc=1387475 |doi= |url=}}</ref>
<ref name="pmid22327883">{{cite journal |vauthors=Wei CH, Harari A |title=Parathyroid carcinoma: update and guidelines for management |journal=Curr Treat Options Oncol |volume=13 |issue=1 |pages=11–23 |date=March 2012 |pmid=22327883 |doi=10.1007/s11864-011-0171-3 |url=}}</ref><ref name="pmid17713315">{{cite journal |vauthors=Sahasranam P, Tran MT, Mohamed H, Friedman TC |title=Multiglandular parathyroid carcinoma: a case report and brief review |journal=South. Med. J. |volume=100 |issue=8 |pages=841–4 |date=August 2007 |pmid=17713315 |doi=10.1097/SMJ.0b013e318073ca37 |url=}}</ref><ref name="pmid4886854">{{cite journal |vauthors=Holmes EC, Morton DL, Ketcham AS |title=Parathyroid carcinoma: a collective review |journal=Ann. Surg. |volume=169 |issue=4 |pages=631–40 |date=April 1969 |pmid=4886854 |pmc=1387475 |doi= |url=}}</ref>
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Malignant]]
* [[Malignant]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Incidence]]: Rare
* [[Incidence]]: Rare
* Mean age : 44 to 54 years
* Mean age : 44-54 years old
* Gender: Female predilection
* Gender: Female predilection
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
*Presents with the [[hyperparathyroidism]]
*Presents with the [[hyperparathyroidism]]
*Bone pains
*[[Bone]] pains
*Stomach pain
*[[Abdominal pain]]
*[[Nausea and vomiting]]
*[[Nausea and vomiting]]
*[[Fatigue]]
*[[Fatigue]]
Line 1,436: Line 1,427:
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
*Low [[TSH]]
*Low [[TSH]]
*Increased T4 and T3
*Increased [[T4]] and [[T3]]
*[[Hypercalcemia]]
*[[Hypercalcemia]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Microscopic]] findings:
* [[Microscopic]] findings:
** [[Tumor]] shows trabecular [[Growth|growth pattern]]
** Trabecular [[Growth|growth pattern]]
** High [[mitosis]]
** High [[mitosis]]
** Surrounding thick fibrotic bands
** Surrounding thick fibrotic bands
** Capsular involvement
** Capsular involvement
** [[Invasion|vascular invasion]] is common
** Vascular [[invasion]] is common
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
*[[Computed tomography|CT]] and [[MRI]] shows more frequent lower lobe involvement, vascular involvement , [[lymph node]] [[metastasis]] and perineural involvement.
*[[Computed tomography|CT]] and [[MRI]] shows more frequent lower lobe involvement, vascular involvement , [[lymph node]] [[metastasis]], and perineural involvement
*[[Bone scan]] may show decreasing [[bone density]]
*[[Bone scan]] may show decreasing [[bone density]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Biopsy]] and [[histopathological]] examination
* [[Biopsy]] and [[histopathological]] examination
| align="center" style="background:#F5F5F5;" |
| align="center" style="background:#F5F5F5;" |
* Hereditary syndromes
* [[Multiple endocrine neoplasia type 2|MEN-2B syndrome]]
* [[Neurofibromatosis type 1]]
* [[VHL syndrome|VHL]] disease
|-
|-
! colspan="2" align="center" style="background:#DCDCDC;" |[[Carotid body tumor|Carotid body tumors]]
! colspan="2" align="center" style="background:#DCDCDC;" |[[Carotid body tumor|Carotid body tumors]]<ref name="pmid174004872">{{cite journal |vauthors=Sajid MS, Hamilton G, Baker DM |title=A multicenter review of carotid body tumour management |journal=Eur J Vasc Endovasc Surg |volume=34 |issue=2 |pages=127–30 |date=August 2007 |pmid=17400487 |doi=10.1016/j.ejvs.2007.01.015 |url=}}</ref><ref name="pmid158837112">{{cite journal |vauthors=Boedeker CC, Ridder GJ, Schipper J |title=Paragangliomas of the head and neck: diagnosis and treatment |journal=Fam. Cancer |volume=4 |issue=1 |pages=55–9 |date=2005 |pmid=15883711 |doi=10.1007/s10689-004-2154-z |url=}}</ref><ref name="pmid15063383">{{cite journal |vauthors=Pellitteri PK, Rinaldo A, Myssiorek D, Gary Jackson C, Bradley PJ, Devaney KO, Shaha AR, Netterville JL, Manni JJ, Ferlito A |title=Paragangliomas of the head and neck |journal=Oral Oncol. |volume=40 |issue=6 |pages=563–75 |date=July 2004 |pmid=15063383 |doi=10.1016/j.oraloncology.2003.09.004 |url=}}</ref><ref name="pmid28478173">{{cite journal |vauthors=Darouassi Y, Alaoui M, Mliha Touati M, Al Maghraoui O, En-Nouali A, Bouaity B, Ammar H |title=Carotid Body Tumors: A Case Series and Review of the Literature |journal=Ann Vasc Surg |volume=43 |issue= |pages=265–271 |date=August 2017 |pmid=28478173 |doi=10.1016/j.avsg.2017.03.167 |url=}}</ref>
<ref name="pmid174004872">{{cite journal |vauthors=Sajid MS, Hamilton G, Baker DM |title=A multicenter review of carotid body tumour management |journal=Eur J Vasc Endovasc Surg |volume=34 |issue=2 |pages=127–30 |date=August 2007 |pmid=17400487 |doi=10.1016/j.ejvs.2007.01.015 |url=}}</ref><ref name="pmid158837112">{{cite journal |vauthors=Boedeker CC, Ridder GJ, Schipper J |title=Paragangliomas of the head and neck: diagnosis and treatment |journal=Fam. Cancer |volume=4 |issue=1 |pages=55–9 |date=2005 |pmid=15883711 |doi=10.1007/s10689-004-2154-z |url=}}</ref><ref name="pmid15063383">{{cite journal |vauthors=Pellitteri PK, Rinaldo A, Myssiorek D, Gary Jackson C, Bradley PJ, Devaney KO, Shaha AR, Netterville JL, Manni JJ, Ferlito A |title=Paragangliomas of the head and neck |journal=Oral Oncol. |volume=40 |issue=6 |pages=563–75 |date=July 2004 |pmid=15063383 |doi=10.1016/j.oraloncology.2003.09.004 |url=}}</ref><ref name="pmid28478173">{{cite journal |vauthors=Darouassi Y, Alaoui M, Mliha Touati M, Al Maghraoui O, En-Nouali A, Bouaity B, Ammar H |title=Carotid Body Tumors: A Case Series and Review of the Literature |journal=Ann Vasc Surg |volume=43 |issue= |pages=265–271 |date=August 2017 |pmid=28478173 |doi=10.1016/j.avsg.2017.03.167 |url=}}</ref>
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
* [[Benign]]
Line 1,459: Line 1,453:
* Age: 26-55 years
* Age: 26-55 years
* Male predominance
* Male predominance
| align="center" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
*A slow growing [[Neck masses|neck mass]]
*A slow growing [[Neck masses|neck mass]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" | −
Line 1,476: Line 1,470:
* Rasised [[catecholamine]] levels
* Rasised [[catecholamine]] levels
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Microscopically they are extra- adrenal [[paragangliomas]]
* Microscopically they are extra-adrenal [[paragangliomas]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
*[[Doppler ultrasound]], [[Computed tomography|CT,]] [[MRI]] and [[angiography]] is used to visualize the [[tumor]].
*[[Doppler ultrasound]], [[Computed tomography|CT,]] [[MRI]] and [[angiography]] is used to visualize the [[tumor]]
*[[Metaiodobenzylguanidine|Metaiodobenzylguanidine (MIBG)]] testing
*[[Metaiodobenzylguanidine|Metaiodobenzylguanidine (MIBG)]] testing
| align="center" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Histopathology]] analysis and [[catecholamine]] levels
* [[Histopathology]] analysis and [[catecholamine]] levels
| align="left" style="background:#F5F5F5;" |-
| align="center" style="background:#F5F5F5;" |
|-
|-
! colspan="2" align="center" style="background:#DCDCDC;" |[[Paraganglioma]]
! colspan="2" align="center" style="background:#DCDCDC;" |[[Paraganglioma]]<ref name="pmid15328326">{{cite journal |vauthors=Neumann HP, Pawlu C, Peczkowska M, Bausch B, McWhinney SR, Muresan M, Buchta M, Franke G, Klisch J, Bley TA, Hoegerle S, Boedeker CC, Opocher G, Schipper J, Januszewicz A, Eng C |title=Distinct clinical features of paraganglioma syndromes associated with SDHB and SDHD gene mutations |journal=JAMA |volume=292 |issue=8 |pages=943–51 |date=August 2004 |pmid=15328326 |doi=10.1001/jama.292.8.943 |url=}}</ref><ref name="pmid11701678">{{cite journal |vauthors=Erickson D, Kudva YC, Ebersold MJ, Thompson GB, Grant CS, van Heerden JA, Young WF |title=Benign paragangliomas: clinical presentation and treatment outcomes in 236 patients |journal=J. Clin. Endocrinol. Metab. |volume=86 |issue=11 |pages=5210–6 |date=November 2001 |pmid=11701678 |doi=10.1210/jcem.86.11.8034 |url=}}</ref><ref name="pmid8678971">{{cite journal |vauthors=O'Riordain DS, Young WF, Grant CS, Carney JA, van Heerden JA |title=Clinical spectrum and outcome of functional extraadrenal paraganglioma |journal=World J Surg |volume=20 |issue=7 |pages=916–21; discussion 922 |date=September 1996 |pmid=8678971 |doi= |url=}}</ref>
<ref name="pmid15328326">{{cite journal |vauthors=Neumann HP, Pawlu C, Peczkowska M, Bausch B, McWhinney SR, Muresan M, Buchta M, Franke G, Klisch J, Bley TA, Hoegerle S, Boedeker CC, Opocher G, Schipper J, Januszewicz A, Eng C |title=Distinct clinical features of paraganglioma syndromes associated with SDHB and SDHD gene mutations |journal=JAMA |volume=292 |issue=8 |pages=943–51 |date=August 2004 |pmid=15328326 |doi=10.1001/jama.292.8.943 |url=}}</ref><ref name="pmid11701678">{{cite journal |vauthors=Erickson D, Kudva YC, Ebersold MJ, Thompson GB, Grant CS, van Heerden JA, Young WF |title=Benign paragangliomas: clinical presentation and treatment outcomes in 236 patients |journal=J. Clin. Endocrinol. Metab. |volume=86 |issue=11 |pages=5210–6 |date=November 2001 |pmid=11701678 |doi=10.1210/jcem.86.11.8034 |url=}}</ref><ref name="pmid8678971">{{cite journal |vauthors=O'Riordain DS, Young WF, Grant CS, Carney JA, van Heerden JA |title=Clinical spectrum and outcome of functional extraadrenal paraganglioma |journal=World J Surg |volume=20 |issue=7 |pages=916–21; discussion 922 |date=September 1996 |pmid=8678971 |doi= |url=}}</ref>
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Benign]] (Majority)
* [[Benign]] (Majority)
[[Malignant]] (rare)
* [[Malignant]] (rare)
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Age 50-70 years
* Age 50-70 years
Line 1,498: Line 1,491:
**Pulse-like vibratory sense
**Pulse-like vibratory sense
**[[Headache]]
**[[Headache]]
**Change in voice Vertigo
**Change in voice  
* [[Catecholamine]] secreting [[paragangliomas]] present with :
**Vertigo
** [[Hypertension]]
*[[Catecholamine]] secreting [[paragangliomas]] presents with :
** [[Headache]]
**[[Hypertension]]
**[[Headache]]
**[[Sweating]]
**[[Sweating]]
**[[Tachycardia]]
**[[Tachycardia]]
Line 1,508: Line 1,502:
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* No visible [[mass]]
* No visible [[mass]]
* Located deep in the the [[neck]] along the [[Glossopharyngeal nerve|glossopharyngeal]] and [[Vagal nerve|vagal nerves]].
* Located deep in the the [[neck]] along the [[glossopharyngeal nerve]]
| align="center" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Associated with some hereditary syndromes and  [[Multiple endocrine neoplasia type 2|MEN2B]] syndrome
* [[Biochemical testing]] may show [[catecholamine]] metabolites in [[serum]] or [[urine]] samples
* [[Neurofibromatosis type 1]] and [[VHL syndrome|VHL]] disease
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Biochemical testing]] may show [[catecholamine]] metabolites in serum or urine samples
* Highly [[vascular tumors]] that involves [[nerves]] around [[vessels]]
| align="left" style="background:#F5F5F5;" |
* [[Gross examination|Gross findings]]:
* These are highly vascular tumors that involves nerves around vessels
**Fleshy [[tumor]]
* [[Gross examination|Gross]] findings:
**Pink to red-brown to gray in color
**<nowiki/>Fleshy [[tumor]]<nowiki/>s
**Pink to red-<nowiki/>brown to gray in color
**Associated with [[hemorrhage]] or [[fibrosis]]
**Associated with [[hemorrhage]] or [[fibrosis]]
* [[Microscopic|Microscopic findings:]]
* [[Microscopic|Microscopic findings]]:
** Round or polygonal cells
** Round or polygonal cells
** Aranged inside capsule
** Nests or trabecular structures inside the capsule
** In the form of nests or forming trabecular structures
* Differentiation between [[benign]] or [[malignancy]] is done depending on:
** [[microscopic]] features
** [[invasion]] and [[Mitotic index|high mitotic index]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Following imaging techniques can be used to diagnose the [[tumor]]:
*[[Ultrasound]]
**[[Ultrasound]]
*[[Computed tomography]]
**[[Computed tomography]]
*[[Magnetic resonance imaging]]
**[[Magnetic resonance imaging]]
*[[Angiography]]
* As these are secretory tumors further testing with following techniques can confirm [[diagnose]]<nowiki/>s:
*[[metaiodobenzylguanidine]] (MIBG)
**[[Angiography]]
*18F-fluoro-2-deoxyglucose Positron emission tomography (FDG-PET)
**[[metaiodobenzylguanidine]] (MIBG)
**18F-fluoro-2-deoxyglucose Positron emission tomography (FDG-PET)
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Imaging]] and [[Catecholamine|serum catecholamine analysis]]
* [[Imaging]] and [[Catecholamine|serum catecholamine analysis]]
| align="left" style="background:#F5F5F5;" |-
| align="center" style="background:#F5F5F5;" |
|-
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
Line 1,556: Line 1,542:
|-
|-
! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Neoplasm
! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Neoplasm
! colspan="2" align="center" style="background:#DCDCDC;" |[[Schwannoma]]
! colspan="2" align="center" style="background:#DCDCDC;" |[[Schwannoma]]<ref name="pmid24450866">{{cite journal |vauthors=Hilton DA, Hanemann CO |title=Schwannomas and their pathogenesis |journal=Brain Pathol. |volume=24 |issue=3 |pages=205–20 |date=April 2014 |pmid=24450866 |doi=10.1111/bpa.12125 |url=}}</ref><ref name="pmid28237565">{{cite journal |vauthors=Albert P, Patel J, Badawy K, Weissinger W, Brenner M, Bourhill I, Parnell J |title=Peripheral Nerve Schwannoma: A Review of Varying Clinical Presentations and Imaging Findings |journal=J Foot Ankle Surg |volume=56 |issue=3 |pages=632–637 |date=2017 |pmid=28237565 |doi=10.1053/j.jfas.2016.12.003 |url=}}</ref><ref name="pmid27020268">{{cite journal |vauthors=Wong BLK, Bathala S, Grant D |title=Laryngeal schwannoma: a systematic review |journal=Eur Arch Otorhinolaryngol |volume=274 |issue=1 |pages=25–34 |date=January 2017 |pmid=27020268 |doi=10.1007/s00405-016-4013-6 |url=}}</ref>
<ref name="pmid24450866">{{cite journal |vauthors=Hilton DA, Hanemann CO |title=Schwannomas and their pathogenesis |journal=Brain Pathol. |volume=24 |issue=3 |pages=205–20 |date=April 2014 |pmid=24450866 |doi=10.1111/bpa.12125 |url=}}</ref><ref name="pmid28237565">{{cite journal |vauthors=Albert P, Patel J, Badawy K, Weissinger W, Brenner M, Bourhill I, Parnell J |title=Peripheral Nerve Schwannoma: A Review of Varying Clinical Presentations and Imaging Findings |journal=J Foot Ankle Surg |volume=56 |issue=3 |pages=632–637 |date=2017 |pmid=28237565 |doi=10.1053/j.jfas.2016.12.003 |url=}}</ref><ref name="pmid27020268">{{cite journal |vauthors=Wong BLK, Bathala S, Grant D |title=Laryngeal schwannoma: a systematic review |journal=Eur Arch Otorhinolaryngol |volume=274 |issue=1 |pages=25–34 |date=January 2017 |pmid=27020268 |doi=10.1007/s00405-016-4013-6 |url=}}</ref>
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
* [[Benign]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Rare [[tumor]]
* Rare [[tumor]]
* Incidence: 1% to 10%
* Incidence: 1-10%
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Slow growing [[mass]]
* Slow growing [[mass]]
* localized neural deficit depending on the site of [[peripheral nerve]] involved.
* Localized neural deficit depending on the site of [[peripheral nerve]] involved
* [[Vagus nerve]] or [[Sympathetic chain|superior cervical sympathetic chain]] involvement (most common locations)
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | ±
| align="left" style="background:#F5F5F5;" |
* Multiple
* Slow growing  [[nodules]] on the skin
| align="left" style="background:#F5F5F5;" |
* [[Vagal]] involvement:
* [[Vagal]] involvement:
** [[Hoarseness]]  
** [[Hoarseness]]  
Line 1,572: Line 1,564:
**[[Dilated pupil]]
**[[Dilated pupil]]
** Decrease [[sweating]]
** Decrease [[sweating]]
** Dropping eye lid
** Dropping eyelid
* Vestibular [[Schwannoma]] (most common):
* [[Vestibular nerve]] involvement & [[Hearing impairment]] (most common)
** [[Hearing impairment]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | ±
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Multiple
* Slow growing  [[nodules]] on the skin
| align="center" style="background:#F5F5F5;" |
* Associated with [[neurofibromatosis type II]].
* Most common nerve involved in [[vestibular nerve]]
| align="center" style="background:#F5F5F5;" |
* May be normal
* May be normal
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* It is a [[peripheral nerve]] [[tumor]]
* Encapsulated neural tissue growth
* [[vagus nerve]] or [[Sympathetic chain|superior cervical sympathetic chain]] being most common locations.
| align="left" style="background:#F5F5F5;" |
* [[Histology]] shows encapsulated neural tissue growth.
* Resembling [[Carotid body tumor]] on [[Computed tomography|CT]]
| align="center" style="background:#F5F5F5;" |
* [[Magnetic resonance imaging|MRI]] and [[Angiography|MRI angiography]] confirm the diagnosis
* [[Imaging]] can diagnose the tumor.
* Its hard to discriminate [[Carotid body tumor]] from [[Schwannoma]] on [[Computed tomography|CT]].
* [[Magnetic resonance imaging|MRI]] and [[Angiography|MRI angiography]] can confirm the diagnoses.
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Imaging]] is used for diagnoses
* [[Imaging]]
| align="center" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |  
* [[neurofibromatosis type II]]
|-
|-
! colspan="2" align="center" style="background:#DCDCDC;" |[[Lymphoma]] <ref name="pmid7139563">{{cite journal |vauthors=Anderson T, Chabner BA, Young RC, Berard CW, Garvin AJ, Simon RM, DeVita VT |title=Malignant lymphoma. 1. The histology and staging of 473 patients at the National Cancer Institute |journal=Cancer |volume=50 |issue=12 |pages=2699–707 |date=December 1982 |pmid=7139563 |doi= |url=}}</ref><ref name="pmid71395632">{{cite journal |vauthors=Anderson T, Chabner BA, Young RC, Berard CW, Garvin AJ, Simon RM, DeVita VT |title=Malignant lymphoma. 1. The histology and staging of 473 patients at the National Cancer Institute |journal=Cancer |volume=50 |issue=12 |pages=2699–707 |date=December 1982 |pmid=7139563 |doi= |url=}}</ref>
! colspan="2" align="center" style="background:#DCDCDC;" |[[Lymphoma]] <ref name="pmid7139563">{{cite journal |vauthors=Anderson T, Chabner BA, Young RC, Berard CW, Garvin AJ, Simon RM, DeVita VT |title=Malignant lymphoma. 1. The histology and staging of 473 patients at the National Cancer Institute |journal=Cancer |volume=50 |issue=12 |pages=2699–707 |date=December 1982 |pmid=7139563 |doi= |url=}}</ref><ref name="pmid71395632">{{cite journal |vauthors=Anderson T, Chabner BA, Young RC, Berard CW, Garvin AJ, Simon RM, DeVita VT |title=Malignant lymphoma. 1. The histology and staging of 473 patients at the National Cancer Institute |journal=Cancer |volume=50 |issue=12 |pages=2699–707 |date=December 1982 |pmid=7139563 |doi= |url=}}</ref><ref name="pmid15185336">{{cite journal |vauthors=Negri E, Little D, Boiocchi M, La Vecchia C, Franceschi S |title=B-cell non-Hodgkin's lymphoma and hepatitis C virus infection: a systematic review |journal=Int. J. Cancer |volume=111 |issue=1 |pages=1–8 |date=August 2004 |pmid=15185336 |doi=10.1002/ijc.20205 |url=}}</ref><ref name="pmid2406917">{{cite journal |vauthors=Moormeier JA, Williams SF, Golomb HM |title=The staging of non-Hodgkin's lymphomas |journal=Semin. Oncol. |volume=17 |issue=1 |pages=43–50 |date=February 1990 |pmid=2406917 |doi= |url=}}</ref><ref name="pmid151853362">{{cite journal |vauthors=Negri E, Little D, Boiocchi M, La Vecchia C, Franceschi S |title=B-cell non-Hodgkin's lymphoma and hepatitis C virus infection: a systematic review |journal=Int. J. Cancer |volume=111 |issue=1 |pages=1–8 |date=August 2004 |pmid=15185336 |doi=10.1002/ijc.20205 |url=}}</ref><ref name="pmid71395633">{{cite journal |vauthors=Anderson T, Chabner BA, Young RC, Berard CW, Garvin AJ, Simon RM, DeVita VT |title=Malignant lymphoma. 1. The histology and staging of 473 patients at the National Cancer Institute |journal=Cancer |volume=50 |issue=12 |pages=2699–707 |date=December 1982 |pmid=7139563 |doi= |url=}}</ref>
<ref name="pmid15185336">{{cite journal |vauthors=Negri E, Little D, Boiocchi M, La Vecchia C, Franceschi S |title=B-cell non-Hodgkin's lymphoma and hepatitis C virus infection: a systematic review |journal=Int. J. Cancer |volume=111 |issue=1 |pages=1–8 |date=August 2004 |pmid=15185336 |doi=10.1002/ijc.20205 |url=}}</ref><ref name="pmid2406917">{{cite journal |vauthors=Moormeier JA, Williams SF, Golomb HM |title=The staging of non-Hodgkin's lymphomas |journal=Semin. Oncol. |volume=17 |issue=1 |pages=43–50 |date=February 1990 |pmid=2406917 |doi= |url=}}</ref><ref name="pmid151853362">{{cite journal |vauthors=Negri E, Little D, Boiocchi M, La Vecchia C, Franceschi S |title=B-cell non-Hodgkin's lymphoma and hepatitis C virus infection: a systematic review |journal=Int. J. Cancer |volume=111 |issue=1 |pages=1–8 |date=August 2004 |pmid=15185336 |doi=10.1002/ijc.20205 |url=}}</ref><ref name="pmid71395633">{{cite journal |vauthors=Anderson T, Chabner BA, Young RC, Berard CW, Garvin AJ, Simon RM, DeVita VT |title=Malignant lymphoma. 1. The histology and staging of 473 patients at the National Cancer Institute |journal=Cancer |volume=50 |issue=12 |pages=2699–707 |date=December 1982 |pmid=7139563 |doi= |url=}}</ref>
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Benign]]/ [[malignant]]
* [[Benign]] or [[malignant]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Age: Predilection for older age
* Age: Predilection for older age
* Mean age: 55
* Mean age: 55
| align="center" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Insidious onset slow growing [[Lymph node|lymph nodes]]
* Insidious onset slow growing [[Lymph node|lymph nodes]]
* Non-specific systemic [[B symptoms]]  
* Non-specific systemic [[B symptoms]]:
** [[fever]]
** [[Fever]]
** [[night sweats]]  
** [[Night sweats]]  
** [[weight loss]])
** [[Weight loss]])
** [[Rash]]
** [[Rash]]
* Waxing and waning [[lymphadenopathy]]  
* Waxing and waning [[lymphadenopathy]]  
* [[Abdominal fullness]] [[hepatomegaly]]  and [[splenomegaly]]
* [[Abdominal fullness]]
* [[Infections]] due to[[cytopenias]]
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" | ±
| align="center" style="background:#F5F5F5;" | ±
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Multiple chain [[lymphadenopathy]]
* Multiple chain [[lymphadenopathy]]
* [[Hepatomegaly]]
* [[Hepatosplenomegaly]]
* [[Splenomegaly]]
* [[Mesenteric]] [[lymphadenopathy]]
* [[Ascites]]
* [[Ascites]]
* [[Auscultation|Chest auscultation]] may show [[crackles]] and [[fibrosis]]
* [[Crackles]] heard on [[Auscultation|chest auscultation]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* With acquired form of C1 inhibitor deficiency patients may develop [[angioedema]]
* [[Rash]] and [[pruritus]]
* [[Rash]] and [[pruritus]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Anemia]]
* [[Pancytopenia]]
* [[Thrombocytopenia]]
* [[Leukopenia]]
* [[Hypercalcemia]]
* [[Hypercalcemia]]
* [[Hyperuricemia]] (increased cell turnover)
* [[Hyperuricemia]] (increased cell turnover)
Line 1,635: Line 1,609:
* Raised [[LDH]] levels
* Raised [[LDH]] levels
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Fine needle aspiration]] (FNA) with cytometry is used for screening.
* Tissue [[biopsy]] is used for diagnose.
* On complete node analysis four patterns are described:
* On complete node analysis four patterns are described:
** Nodular/follicular
** Nodular/follicular
Line 1,643: Line 1,615:
** Transition from a lower to a higher grade of involvement within a single node
** Transition from a lower to a higher grade of involvement within a single node
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Imaging is used to stage the disease.
* Imaging to stage the disease
* [[Positron emission tomography]] with computed tomography ([[PET scan|PET]]/[[Computed tomography|CT]]) is preferred over [[MRI]].
* [[Positron emission tomography]] with computed tomography is preferred over [[MRI]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Lymph node]] biopsy coupled with cytometry
* [[Lymph node]] biopsy coupled with [[cytometry]]
| align="center" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |  
* [[Infections]] due to [[cytopenias]]
* With acquired form of [[C1 inhibitor deficiency]] patients may develop [[angioedema]]
|-
|-
! colspan="2" align="center" style="background:#DCDCDC;" |[[Liposarcoma]] <ref name="pmid171979142">{{cite journal |vauthors=Evans HL |title=Atypical lipomatous tumor, its variants, and its combined forms: a study of 61 cases, with a minimum follow-up of 10 years |journal=Am. J. Surg. Pathol. |volume=31 |issue=1 |pages=1–14 |date=January 2007 |pmid=17197914 |doi=10.1097/01.pas.0000213406.95440.7a |url=}}</ref><ref name="pmid21253554">{{cite journal |vauthors=Conyers R, Young S, Thomas DM |title=Liposarcoma: molecular genetics and therapeutics |journal=Sarcoma |volume=2011 |issue= |pages=483154 |date=2011 |pmid=21253554 |pmc=3021868 |doi=10.1155/2011/483154 |url=}}</ref><ref name="pmid19194281">{{cite journal |vauthors=Alaggio R, Coffin CM, Weiss SW, Bridge JA, Issakov J, Oliveira AM, Folpe AL |title=Liposarcomas in young patients: a study of 82 cases occurring in patients younger than 22 years of age |journal=Am. J. Surg. Pathol. |volume=33 |issue=5 |pages=645–58 |date=May 2009 |pmid=19194281 |doi=10.1097/PAS.0b013e3181963c9c |url=}}</ref><ref name="pmid176106862">{{cite journal |vauthors=Serpell JW, Chen RY |title=Review of large deep lipomatous tumours |journal=ANZ J Surg |volume=77 |issue=7 |pages=524–9 |date=July 2007 |pmid=17610686 |doi=10.1111/j.1445-2197.2007.04042.x |url=}}</ref>
! colspan="2" align="center" style="background:#DCDCDC;" |[[Liposarcoma]] <ref name="pmid171979142">{{cite journal |vauthors=Evans HL |title=Atypical lipomatous tumor, its variants, and its combined forms: a study of 61 cases, with a minimum follow-up of 10 years |journal=Am. J. Surg. Pathol. |volume=31 |issue=1 |pages=1–14 |date=January 2007 |pmid=17197914 |doi=10.1097/01.pas.0000213406.95440.7a |url=}}</ref><ref name="pmid21253554">{{cite journal |vauthors=Conyers R, Young S, Thomas DM |title=Liposarcoma: molecular genetics and therapeutics |journal=Sarcoma |volume=2011 |issue= |pages=483154 |date=2011 |pmid=21253554 |pmc=3021868 |doi=10.1155/2011/483154 |url=}}</ref><ref name="pmid19194281">{{cite journal |vauthors=Alaggio R, Coffin CM, Weiss SW, Bridge JA, Issakov J, Oliveira AM, Folpe AL |title=Liposarcomas in young patients: a study of 82 cases occurring in patients younger than 22 years of age |journal=Am. J. Surg. Pathol. |volume=33 |issue=5 |pages=645–58 |date=May 2009 |pmid=19194281 |doi=10.1097/PAS.0b013e3181963c9c |url=}}</ref><ref name="pmid176106862">{{cite journal |vauthors=Serpell JW, Chen RY |title=Review of large deep lipomatous tumours |journal=ANZ J Surg |volume=77 |issue=7 |pages=524–9 |date=July 2007 |pmid=17610686 |doi=10.1111/j.1445-2197.2007.04042.x |url=}}</ref>
Line 1,653: Line 1,627:
* [[Malignant]]
* [[Malignant]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Rare [[tumors]]
* Rare [[tumor]]
* Age: Relatively in older age
* Age: Relatively in older age
* Gender: No gender predilection
* Gender: No gender predilection
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Mobile [[Mass|mass]]  
* Mobile [[Mass|mass]]  
* Few symptoms until they grow enough to compress the surrounding structures
* Few symptoms until they grow enough to compress the surrounding structures
* Symptoms of neural deficit, pain, tingling or skin changes.
* Symptoms of [[neural]] deficit, pain, [[tingling]], or [[skin]] changes
| align="center" style="background:#F5F5F5;" | ±
| align="center" style="background:#F5F5F5;" | ±
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" | −
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Mobile soft [[mass]]
* Mobile soft [[mass]]
* Intact overlying skin
* Intact overlying [[skin]]
* Blue discoloration due to intra-lesion [[hemorrhage]]
* Blue discoloration due to intra-lesion [[hemorrhage]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Intact skin and normal color
* Intact [[skin]] and normal color
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Normal
* Normal
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Gross examination|Gross]] findings:
* [[Gross examination]]:
**Bulk of yellow colored fat tissue
**Bulk of yellow colored [[fat tissue]]
* [[Microscopic|Microscopic features]]:
* [[Microscopic|Microscopic features]]:
** [[Adipose tissue]] containing lipoblasts
** [[Adipose tissue]] containing lipoblasts
** Atypical [[nucleus]] pushed to side by intracytoplasmic vacuoles.
** Atypical [[nucleus]] pushed to side by intracytoplasmic vacuoles
** Tissue biopsy may show [[histological]] sub-groups:
* Tissue [[biopsy]] may show [[histological]] sub-groups:
** Well-differentiated
** Well-differentiated
** Myxoid/round cell
** Myxoid/round cell
** Pleomorphic liposarcomas
** Pleomorphic liposarcomas
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Imaging]] is not usually used for diagnoses
* [[Imaging]] not usually required for diagnosis
* Except to look for deeper [[invasion]].
* May show deeper [[invasion]]
* [[Ultrasound]] shows homogeneous hyperechoic [[mass]].
* [[Ultrasound]] shows homogeneous hyperechoic [[mass]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Biopsy]] and [[Histopathology|histopathology analysis]]
* [[Biopsy]] and [[Histopathology|histopathology analysis]]
Line 1,711: Line 1,685:
* Unspecific gender or age association
* Unspecific gender or age association
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* One or multiple soft, painless skin nodules.
* One or multiple soft, painless skin [[nodules]]
* May causes pain or compressive [[symptoms]]
* May causes pain or compressive [[symptoms]]
| align="center" style="background:#F5F5F5;" | ±
| align="center" style="background:#F5F5F5;" | ±
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" | −
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Mobile soft nodule
* Mobile soft [[nodule]]
* Intact overlying skin
* Intact overlying [[skin]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Intact skin and normal color
* Normal
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Normal
* Normal
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Diagnoses is usually [[clinical]]
* Diagnoses is usually [[clinical]]
* Tissue [[biopsy]] may show
* Tissue [[biopsy]] may show:
 
** Bundle of well-demarcated lipocytes
* Bundle of well-demarcated lipocytes
** Single [[nuclei]] aligned to the side
* Single [[nuclei]] aligned to the side
** Intra-cytoplasimic fat granules
* Intra-cytoplasimic fat granules.
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Diagnoses is usually clinical  
* Diagnosis is usually clinical
* [[ultrasound]] is used to differentiate [[lipoma]] from other [[benign]] lesions such as:
* [[ultrasound]] is used to differentiate [[lipoma]] from other [[benign]] lesions such as:
* [[epidermoid cyst]] or a [[ganglion]].
** [[Epidermoid cyst]]  
** A [[ganglion]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Clinical]] evaluation
* [[Clinical]] evaluation
and tissue [[biopsy]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Multiple [[lipomas]]
* Multiple [[lipomas]]
* Associated with [[familial]] multiple lipomatosis
* Associated with [[familial multiple lipomatosis]]
|-
|-
! colspan="2" align="center" style="background:#DCDCDC;" |Glomus vagale, [[Glomus jugulare tumor|glomus jugulare]] tumors
! colspan="2" align="center" style="background:#DCDCDC;" |Glomus vagale, [[Glomus jugulare tumor|glomus jugulare]] tumors<ref name="pmid8164483">{{cite journal |vauthors=Urquhart AC, Johnson JT, Myers EN, Schechter GL |title=Glomus vagale: paraganglioma of the vagus nerve |journal=Laryngoscope |volume=104 |issue=4 |pages=440–5 |date=April 1994 |pmid=8164483 |doi=10.1288/00005537-199404000-00008 |url=}}</ref><ref name="pmid6308990">{{cite journal |vauthors=Valavanis A, Schubiger O, Oguz M |title=High-resolution CT investigation of nonchromaffin paragangliomas of the temporal bone |journal=AJNR Am J Neuroradiol |volume=4 |issue=3 |pages=516–9 |date=1983 |pmid=6308990 |doi= |url=}}</ref><ref name="pmid81644832">{{cite journal |vauthors=Urquhart AC, Johnson JT, Myers EN, Schechter GL |title=Glomus vagale: paraganglioma of the vagus nerve |journal=Laryngoscope |volume=104 |issue=4 |pages=440–5 |date=April 1994 |pmid=8164483 |doi=10.1288/00005537-199404000-00008 |url=}}</ref><ref name="pmid1988766">{{cite journal |vauthors=Stein PP, Black HR |title=A simplified diagnostic approach to pheochromocytoma. A review of the literature and report of one institution's experience |journal=Medicine (Baltimore) |volume=70 |issue=1 |pages=46–66 |date=January 1991 |pmid=1988766 |doi= |url=}}</ref><ref name="pmid17400487">{{cite journal |vauthors=Sajid MS, Hamilton G, Baker DM |title=A multicenter review of carotid body tumour management |journal=Eur J Vasc Endovasc Surg |volume=34 |issue=2 |pages=127–30 |date=August 2007 |pmid=17400487 |doi=10.1016/j.ejvs.2007.01.015 |url=}}</ref><ref name="pmid15883711">{{cite journal |vauthors=Boedeker CC, Ridder GJ, Schipper J |title=Paragangliomas of the head and neck: diagnosis and treatment |journal=Fam. Cancer |volume=4 |issue=1 |pages=55–9 |date=2005 |pmid=15883711 |doi=10.1007/s10689-004-2154-z |url=}}</ref>
<ref name="pmid8164483">{{cite journal |vauthors=Urquhart AC, Johnson JT, Myers EN, Schechter GL |title=Glomus vagale: paraganglioma of the vagus nerve |journal=Laryngoscope |volume=104 |issue=4 |pages=440–5 |date=April 1994 |pmid=8164483 |doi=10.1288/00005537-199404000-00008 |url=}}</ref><ref name="pmid6308990">{{cite journal |vauthors=Valavanis A, Schubiger O, Oguz M |title=High-resolution CT investigation of nonchromaffin paragangliomas of the temporal bone |journal=AJNR Am J Neuroradiol |volume=4 |issue=3 |pages=516–9 |date=1983 |pmid=6308990 |doi= |url=}}</ref><ref name="pmid81644832">{{cite journal |vauthors=Urquhart AC, Johnson JT, Myers EN, Schechter GL |title=Glomus vagale: paraganglioma of the vagus nerve |journal=Laryngoscope |volume=104 |issue=4 |pages=440–5 |date=April 1994 |pmid=8164483 |doi=10.1288/00005537-199404000-00008 |url=}}</ref><ref name="pmid1988766">{{cite journal |vauthors=Stein PP, Black HR |title=A simplified diagnostic approach to pheochromocytoma. A review of the literature and report of one institution's experience |journal=Medicine (Baltimore) |volume=70 |issue=1 |pages=46–66 |date=January 1991 |pmid=1988766 |doi= |url=}}</ref><ref name="pmid17400487">{{cite journal |vauthors=Sajid MS, Hamilton G, Baker DM |title=A multicenter review of carotid body tumour management |journal=Eur J Vasc Endovasc Surg |volume=34 |issue=2 |pages=127–30 |date=August 2007 |pmid=17400487 |doi=10.1016/j.ejvs.2007.01.015 |url=}}</ref><ref name="pmid15883711">{{cite journal |vauthors=Boedeker CC, Ridder GJ, Schipper J |title=Paragangliomas of the head and neck: diagnosis and treatment |journal=Fam. Cancer |volume=4 |issue=1 |pages=55–9 |date=2005 |pmid=15883711 |doi=10.1007/s10689-004-2154-z |url=}}</ref>
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Benign]]
* [[Benign]]
Line 1,747: Line 1,719:
* Rare tumor
* Rare tumor
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Painless slowly enlarging [[Mass|mass in the neck]]
* Painless slowly enlarging [[Mass|mass]] in the [[neck]]
* May have compressive symptoms such as:
** [[Dysphagia]]
** [[Hoarseness]]
** [[Cranial nerves]] deficits
** [[Horner's syndrome]]
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" | ±
| align="center" style="background:#F5F5F5;" | ±
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Non-compressible
* Non-compressible
* Firm
* Firm
* Non-tender [[swelling]]  
* Non-tender [[swelling]]  
* Absent [[thrill]] or [[bruit]]<nowiki/>differentiates it from [[Aneurysm|carotid aneurysm]]
* No [[thrill]] or [[bruit]]
* Normal overlying skin.
* Normal overlying skin
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Secretory tumors
* Secretory tumors
* Diagnosed by biochemical testing:
* May have compressive signs such as:
** [[Metaiodobenzylguanidine]] (MIBG)
** [[Dysphagia]]
** Followed by [[imaging]] to locate the [[tumor]]
** [[Hoarseness]]
** [[Cranial nerves]] deficits
** [[Horner's syndrome]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Normal
* Normal
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Glomus tumor|Glomus tumors]] arise from Non [[Chromaffin cells]]
* [[Glomus tumor|Glomus tumors]] arise from Non [[Chromaffin cells]]
* [[histopathology]] reveals "salt and pepper" [[chromatin]] which is typical of tumor.
* [[histopathology]] reveals "salt and pepper" [[chromatin]]
* On [[immunohistochemistry]] [[Tumor cell|tumor]] cells show [[chromogranin]] and [[S-100]] positivisty
* On [[immunohistochemistry]] [[Tumor cell|tumor cells]] show [[chromogranin]] and [[S-100]] positivity
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Imaging]] of  choice is [[MRI]]
* [[MRI]] ([[Imaging]] of choice): Typical appearance of the [[tumor]] along [[vagus nerve]]
* [[MRI]]:  
* [[Ultrasonography]] (early stage of diagnosis): Isoechoic to hypoechoic well defined [[tumor]]
** Show typical appearance of the [[tumor]] along [[Vagus nerve]].
* [[CT-scans|CT]]: Vascularity of the [[tumor]]
* [[Ultrasonography|USG]] :
* Biochemical testing: Shows secretary nature of the [[tumor]]
** Used to see the [[tumor]] in early stage of diagnoses.
** [[Ultrasonography|US]] shows isoechoic to hypoechoic well defined [[tumor]]
* [[CT-scans|CT]]:
** To see vascularity of tumor.
* Biochemical testing to see secretary nature of [[tumor]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Imaging]] and MIBG testing
* [[Imaging]] and [[Metaiodobenzylguanidine]] (MIBG) testing
| align="center" style="background:#F5F5F5;" | −
| align="center" style="background:#F5F5F5;" | −
|-
|-
! colspan="2" align="center" style="background:#DCDCDC;" |[[Head and neck cancer|Metastatic head and neck cancer]]
! colspan="2" align="center" style="background:#DCDCDC;" |[[Head and neck cancer|Metastatic head and neck cancer]]<ref name="pmid2211107">{{cite journal |vauthors=Gluckman JL, Robbins KT, Fried MP |title=Cervical metastatic squamous carcinoma of unknown or occult primary source |journal=Head Neck |volume=12 |issue=5 |pages=440–3 |date=1990 |pmid=2211107 |doi= |url=}}</ref><ref name="pmid19841343">{{cite journal |vauthors=Waltonen JD, Ozer E, Hall NC, Schuller DE, Agrawal A |title=Metastatic carcinoma of the neck of unknown primary origin: evolution and efficacy of the modern workup |journal=Arch. Otolaryngol. Head Neck Surg. |volume=135 |issue=10 |pages=1024–9 |date=October 2009 |pmid=19841343 |doi=10.1001/archoto.2009.145 |url=}}</ref>
<ref name="pmid2211107">{{cite journal |vauthors=Gluckman JL, Robbins KT, Fried MP |title=Cervical metastatic squamous carcinoma of unknown or occult primary source |journal=Head Neck |volume=12 |issue=5 |pages=440–3 |date=1990 |pmid=2211107 |doi= |url=}}</ref><ref name="pmid19841343">{{cite journal |vauthors=Waltonen JD, Ozer E, Hall NC, Schuller DE, Agrawal A |title=Metastatic carcinoma of the neck of unknown primary origin: evolution and efficacy of the modern workup |journal=Arch. Otolaryngol. Head Neck Surg. |volume=135 |issue=10 |pages=1024–9 |date=October 2009 |pmid=19841343 |doi=10.1001/archoto.2009.145 |url=}}</ref>
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Malignant]]
* [[Malignant]]
Line 1,805: Line 1,767:
* Majority of metastatic [[head and neck cancer]]  
* Majority of metastatic [[head and neck cancer]]  
* Metastatise from [[Gastrointestinal tract|GIT]] and lungs
* Metastatise from [[Gastrointestinal tract|GIT]] and lungs
* Are [[Squamous cell carcinoma|squamous cell caners]] by type
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* Vary depending on the underlying [[cancer]]
* Vary depending on the underlying [[cancer]]
Line 1,811: Line 1,772:
* [[Histology]] of primary cancer
* [[Histology]] of primary cancer
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Computed tomography|CT]] and [[Magnetic resonance imaging|MRI]]:
* [[Computed tomography|CT]] and [[Magnetic resonance imaging|MRI]] to see extent of [[tumor]]
** To see extent of [[tumor]]
** And regions of [[metastasis]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
* [[Biopsy]] and [[histopathology]] of the primary site of [[tumor]]
* [[Biopsy]] and [[histopathology]] of the primary site of [[tumor]]
| align="left" style="background:#F5F5F5;" | -
| align="center" style="background:#F5F5F5;" |
|-
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
Line 1,834: Line 1,793:
|-
|-
! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
! colspan="2" align="center" style="background:#DCDCDC;" |[[Laryngeal cancer]]
! colspan="2" align="center" style="background:#DCDCDC;" |[[Laryngeal cancer]]<ref name="pmid6639441">{{cite journal |vauthors=Feldman PS, Kaplan MJ, Johns ME, Cantrell RW |title=Fine-needle aspiration in squamous cell carcinoma of the head and neck |journal=Arch Otolaryngol |volume=109 |issue=11 |pages=735–42 |date=November 1983 |pmid=6639441 |doi= |url=}}</ref><ref name="pmid26237923">{{cite journal |vauthors=Grénman R, Koivunen P, Minn H |title=[Laryngeal cancer in Finland] |language=Finnish |journal=Duodecim |volume=131 |issue=4 |pages=331–7 |date=2015 |pmid=26237923 |doi= |url=}}</ref>
<ref name="pmid6639441">{{cite journal |vauthors=Feldman PS, Kaplan MJ, Johns ME, Cantrell RW |title=Fine-needle aspiration in squamous cell carcinoma of the head and neck |journal=Arch Otolaryngol |volume=109 |issue=11 |pages=735–42 |date=November 1983 |pmid=6639441 |doi= |url=}}</ref><ref name="pmid26237923">{{cite journal |vauthors=Grénman R, Koivunen P, Minn H |title=[Laryngeal cancer in Finland] |language=Finnish |journal=Duodecim |volume=131 |issue=4 |pages=331–7 |date=2015 |pmid=26237923 |doi= |url=}}</ref>
| align="left" style="background:#F5F5F5;" |[[Benign]]/[[Malignant]]
| align="left" style="background:#F5F5F5;" |[[Benign]]/[[Malignant]]
| align="left" style="background:#F5F5F5;" |
| align="left" style="background:#F5F5F5;" |
Line 1,964: Line 1,922:
==References==
==References==
{{reflist|2}}
{{reflist|2}}
[[Category:Up-To-Date]]
[[Category:Up-To-Date]]
[[Category:Medicine]]
[[Category:Medicine]]
Line 1,978: Line 1,937:
[[Category:Vascular medicine]]
[[Category:Vascular medicine]]
[[Category:Surgery]]
[[Category:Surgery]]
[[Category:Primary care]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Differential diagnosis]]
[[Category:Differential diagnosis]]

Latest revision as of 22:55, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maneesha Nandimandalam, M.B.B.S.[2], Gertrude Djouka, M.D.[3], Qurrat-ul-ain Abid, M.D.[4]

Overview

Neck masses must be differentiated from congenital abnormalities, inflammatory, and malignant lesions.

Differentiating neck masses from other Diseases

Neck masses must be differentiated from congenital abnormalities, inflammatory, and malignant lesions.

Category Diseases Benign/

Malignant

Clinical manifestation Paraclinical findings Gold standard diagnosis Associated findings
Demography History Symptoms Signs Lab findings Histopathology Imaging
Pain Dysphagia Mass exam Others
Congenital Branchial cleft cyst[1]
  • Age: 1-15 years old
  • Familial occurrence
  • Lateral neck mass
±
  • Solitary
  • Smooth
  • Mobile
  • Well-defined
  • Non-pulsatile
  • Fluctuant
  • A pit at the opening of the cyst
Thyroglossal duct cyst[2][3]
  • Age: 1-10 years old
  • Midline neck mass
Hemangioma[4]
  • Presents with a flat red or purple patch
  • Regress gradually with age
  • Firm
  • Rubbery
  • Well-demarcated
Vascular malformation[5][6]
  • Incidence: 1 in 2000 to 5000 births
  • Gender: No predilection
±
  • Grow proportionally with age
  • MRI
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Congenital Lymphatic malformation[7][8]
  • Age: Birth-5 years old
  • Gender: No predilection
+
Laryngocele[9][10][11] +
  • Soft
  • Reducible
  • Increase in size on valsalva
  • Common in glass blowers and trumpet players
Ranula[12][13]
  • Well circumscribed
  • Fluctuant
  • Soft
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Congenital Teratoma[14][15]
  • Incidence: 1:4000 births
  • Gender: No predilection
  • Presents as a firm lateral neck mass
  • Firm
  • Non-tender
  • High ALP levels
Dermoid cyst[16][17]
  • Freely mobile
  • Solitary
  • Rubbery
  • Nonpulsatile
  • Noncompressible
  • Ultrasound: Thin walled, unilocular
  • CT with contrast: Well circumscribed, unilocular, sac-of-marbles appearance due to fatty tissue
Thymic cyst[18]
  • Presents as a soft mass, gradually enlarging, on left side of the neck (usual)
  • Soft
  • Compressible
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Inflammatory Acute sialadenitis[19]
  • Age: Occurs in all age groups
  • Gender: No predilection
+ -
Chronic sialadenitis[20]
  • Age: Occurs in all age groups
  • Gender: No predilection
  • Presents with an unilateral swelling
  • Recurrent episodes common
+
  • Non-tender
  • Firm
  • Smooth
Reactive viral lymphadenopathy CMV[21]
  • Age: 10-35 years old
  • Gender: No predilection
  • Flu-like illness
  • Non-tender
  • Soft
  • Usually not necessary
EBV[22][23]
  • Age: Mainly adolescents
  • Gender: No predilection
  • Non-tender
  • Firm
  • Usually not necessary
HIV[24]
  • Non-tender mass
  • Usually not necessary
Viral URI[25]
  • Incidence: More in fall & winter
  • Age: Common in elderly and infants
  • Non-tender
  • No specific findings
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Inflammatory Bacterial lymphadenopathy Tularemia[26][27]
  • Age: Affects all age groups
  • Gender: No predilection
+
  • No specific findings
Brucellosis[28]
  • Flu-like illness
+
  • No specific findings
Cat-scratch disease[29][30]
  • More common in the Southern of U.S among children and young adults
+
Actinomycosis[31][32]
  • No predilection in race, age
  • [[Male] to female ratio : 1.5 to 3:1
  • Tender at the beginning
  • Painless
  • Fluctuant
  • Non-tender at late stage
Mycobacterial infections[22][33][34]
Streptococcal infection[21][35] + +
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Inflammatory Parasitic lymphadenopathy Toxoplasma gondii[36][37]
  • 6 years old and older adults are more affected in U.S.
  • Seen in hot climates
+
  • Bilateral
  • Non-tender
  • Symmetrical
  • Non-fluctuant
Sarcoidosis[38][19]
  • More common in African American women aged 20-40 years
Sjögren syndrome[39]
  • Female to male ratio: 9 to 1
  • May happen at any age
  • Mean age: 40-50
+
Castleman disease (angiofollicular lymphoproliferative disease)[40][41]
  • Mean age: 30-40 years
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Inflammatory Kikuchi disease (histiocytic necrotizing lymphadenitis)[42]
  • High prevalence in Japan
  • More common in young adults < 30 years old
+
Kimura disease[43]
  • More common in Asian males
Rosai-Dorfman disease[44][45]
Kawasaki disease[46][47]
  • More common in children < 5 years old
  • Highest incidence in Japan
  • Most leading cause of acquired heart disease in U.S
Category Diseases Benign or Malignant Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Neoplasm Salivary gland neoplasm Pleomorphic adenoma[48][49] +
  • MRI: Homogenous on T1
  • Abundant myxochondroid stroma on T2
Warthin's tumor[50][51]
  • Male to female ratio: 4:1
  • More common in people aged 60-70 years old
+
Oncocytoma

[52]

  • Race: Caucasian patients predilection
  • Gender: No gender preference
  • Age: 50–70 years
± ±
  • CT:
    • Isodense expansive mass
    • Enhancement after intravenous contrast
    • Hypodense areas
  • MRI:
    • Isodensties on T1
    • Mass is hyperintense on T2
    • Enhancement on contrast
-
Monomorphic adenoma [53][54][55]
  • Age: 26-76 years
  • Rare in children
  • Gender: No predilection
± ±
  • Normal
-
Mucoepidermoid carcinoma

[56]

  • Age: Mean age of 59
  • Female predilection
± ±
  • Cystic and solid component with variable appearance on CT and MRI
  • Association with CMV
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Neoplasm Salivary gland neoplasm Adenoid cystic carcinoma [57]
  • Age: 40s-60s
  • Gender: Female predominance
± ±
Adenocarcinoma

[58]

  • Age: young age predilection
Salivary duct cancer[59][60][61]

(Highly aggressive)

  • Incidence: 1-3%
  • Gender: Male predilection
  • Mean age: 55-61 years old
  • Rapidly growing mass with jaw involvement
± ±
  • Painless
  • Hard
  • Non-compressible mass
Squamous cell carcinoma[62][63]
  • Incidence: rare
  • Age: Old age , 61-68 years
  • Male predilection
  • Present as painful growing mass on jaw
+
  • Tumor dimension can be delineated using both CT and MRI
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Neoplasm Hypopharyngeal cancer[64][65][66]
  • More common in males
  • Age: 55-65 years old
  • Incidence: < 1/100,000 in U.S.
  • More common in Japan, India, Iran
+
Parathyroid cancer[67][68][69]
  • Incidence: Rare
  • Mean age : 44-54 years old
  • Gender: Female predilection
+ +
Carotid body tumors[70][71][72][73]
  • Age: 26-55 years
  • Male predominance
+
Paraganglioma[74][75][76]
  • Age 50-70 years
  • More in females
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Neoplasm Schwannoma[77][78][79]
  • Rare tumor
  • Incidence: 1-10%
+ ±
  • Multiple
  • Slow growing nodules on the skin
  • May be normal
  • Encapsulated neural tissue growth
Lymphoma [80][81][82][83][84][85]
  • Age: Predilection for older age
  • Mean age: 55
±
  • On complete node analysis four patterns are described:
    • Nodular/follicular
    • Diffuse pattern
    • Transition from a nodular to a diffuse pattern in adjacent nodes
    • Transition from a lower to a higher grade of involvement within a single node
Liposarcoma [86][87][88][89]
  • Rare tumor
  • Age: Relatively in older age
  • Gender: No gender predilection
  • Mobile mass
  • Few symptoms until they grow enough to compress the surrounding structures
  • Symptoms of neural deficit, pain, tingling, or skin changes
±
  • Intact skin and normal color
  • Normal
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Neoplasm Lipoma [90][91][92]
  • One or multiple soft, painless skin nodules
  • May causes pain or compressive symptoms
±
  • Normal
  • Normal
  • Diagnoses is usually clinical
  • Tissue biopsy may show:
    • Bundle of well-demarcated lipocytes
    • Single nuclei aligned to the side
    • Intra-cytoplasimic fat granules
Glomus vagale, glomus jugulare tumors[93][94][95][96][97][98]
  • Rare tumor
  • Painless slowly enlarging mass in the neck
±
  • Normal
Metastatic head and neck cancer[99][100] ±
  • Vary depending on the underlying cancer
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Other Laryngeal cancer[101][102] Benign/Malignant
  • Older males
  • Younger patients with HPV infection or smoking history
± ±

human papillomavirus (HPV) infection

Arteriovenous fistula

[103][104]

  • Depends on the risk factors
  • Varies depending on the etiology
Thyroid nodule/ Goiter

[105][106][107][108]

  • Female predominance
  • Young age (benign causes)
  • Old age (malignant etiology)
± ±
  • Painless
  • Non-tender
  • Asymmetrical neck mass in front of neck
  • With smooth overlying skin
  • Nodular surface
  • Depending on the type:
  • Normal to low TSH levels in case of malignancy
  • High TSH levels in case of goiter
Category Diseases Benign Demography History Pain Dysphagia Mass exam Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings

References

  1. Nahata, Vaishali (2016). "Branchial cleft cyst". Indian Journal of Dermatology. 61 (6): 701. doi:10.4103/0019-5154.193718. ISSN 0019-5154.
  2. Amos J, Shermetaro C. PMID 30085599. Missing or empty |title= (help)
  3. Deaver MJ, Silman EF, Lotfipour S (August 2009). "Infected thyroglossal duct cyst". West J Emerg Med. 10 (3): 205. PMC 2729228. PMID 19718389.
  4. Léauté-Labrèze, C.; Prey, S.; Ezzedine, K. (2011). "Infantile haemangioma: Part I. Pathophysiology, epidemiology, clinical features, life cycle and associated structural abnormalities". Journal of the European Academy of Dermatology and Venereology. 25 (11): 1245–1253. doi:10.1111/j.1468-3083.2011.04102.x. ISSN 0926-9959.
  5. Cox JA, Bartlett E, Lee EI (May 2014). "Vascular malformations: a review". Semin Plast Surg. 28 (2): 58–63. doi:10.1055/s-0034-1376263. PMC 4078214. PMID 25045330.
  6. Behravesh S, Yakes W, Gupta N, Naidu S, Chong BW, Khademhosseini A, Oklu R (December 2016). "Venous malformations: clinical diagnosis and treatment". Cardiovasc Diagn Ther. 6 (6): 557–569. doi:10.21037/cdt.2016.11.10. PMC 5220204. PMID 28123976.
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