Lecture3- Head and neck lumps

Question 1

Neck lumps can be classified into two categories, what are these?

Answer 1

Benign and Malignant

Question 2

Of Benign lumps what are the 5 classifications?

Answer 2

Lymphoid, thyroid, salivary, Infection, Congenital

Question 3

What are the 4 possible types of malignant lumps?

Answer 3

Lymphoma, Salivary, Thyroid, Metatstatic

Question 4

In order to diagnose a lump what are the steps that you would take?

Answer 4

History Local examination, Regional examination, General examination, Provisional diagnosis Special tests Decide whether to refer or not?

Question 5

When thinking about neck lumps you should think about what tissue is beneath the area. Recall the lymph nodes and neck triangles and their location?

Answer 5

See the diagram of anatomy in the lateral neck region.

Question 6

When carrying out histopathology and cytology what are the ways of retrieving the cells.

Answer 6

• FNAC,
• TRUCUT (Used in Lymphoma)
• CELL blocks (Centrifuged needle washings)
• Imprint cytology
• open biopsy
• resection

Question 7

When taking a blood test, what tests are requested?

Answer 7

Full blood count, Urea and Electrolytes (U&E), Specific antibodies and thyroid function.

Question 8

What are the different types of radiographical investigations?

Answer 8

Plain, CT, MRI, Sialography. Isotope, PET.

Question 9

What anatomy is present in the midline of the neck?

Answer 9

Question 10

Neck Pathology can be identified as either congenital or acquired, What are the 5 congenital causes of neck lumps?

Answer 10

• Lymphangioma
• Dermoid cysts
• Thyroglossal cysts
• Branchial cysts
• Pharyngeal pouch

Question 11

What are the 8 Acquired causes of neck lumps? (TIIINMAN)

Answer 11

• Trauma
• Infective
• Inflammatory
• Iatrogenic
• Neoplastic
• Metabolic
• Autoimmune
• No idea

Question 12

What trauma can lead to neck lumps?

Answer 12

• Heamatoma

Question 13

When referring to thyroid cytology, there is a system determining whether the thyroid tissue is malignant or not. (Th1-TH5)

Answer 13

• TH1- Inadequate
• Th2- Benign
• th3- Follicular
• Th4-suspicious for malignancy
• Th5- Malignant.

Question 14

What infections can cause neck lumps?

Answer 14

• Cat scratch disease
• Dental infection
• Neck space infections
• EBv
• Toxoplasma
• TB
• CMV
• HIV

Question 15

What are the inflammatory causes of neck lumps?

Answer 15

• Sialadenitis
• Sarcoidosis
• Rheumatoid

Question 16

Neoplastic lumps can be either….

Question 17

What Major anatomy can be identified in this image?

Question 18

Malignant neck lumps are classified into two catagories, what are these?

Answer 18

Primary or Metastatic

Question 20

What are the red flags for diagnosing neck lumps?

Answer 20

• Rapid growth
• Effect on adjacent structures (effect on facial nerve,recurrent laryngeal), skin and airway
• Risk Factors (Smoking, FH, Radiation, Previous, Age)
• Systemic factors ( Weight loss and other b symptoms)