Sandbox: Gertrude

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: , Gertrude Djouka, M.D.[2]

Differential diagnosis of neck masses==

Differential diagnosis of neck masses include:

Category Diseases Benign or Malignant Clinical manifestation Paraclinical findings Gold standard diagnosis Associated findings
Demography History Symptoms Signs Lab findings Histopathology Imaging
Pain Dysphagia Mass exam Skin changes LAP Others
Congenital Branchial cleft cyst Benign
Thyroglossal duct cyst
Hemangioma
Vascular malformations
Lymphatic malformations
Laryngocele
Ranula
Teratoma
Dermoid cyst
Thymic cyst
Category Diseases Benign or Malignant Demography History Pain Dysphagia Mass exam Skin changes LAP Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Inflammatory Acute sialadenitis
Chronic sialadenitis
Reactive viral lymphadenopathy CMV
EBV
HIV
Viral URI
Bacterial lymphadenopathy Tularemia
Brucellosis
Cat-scratch disease Benign Cat exposure +
Actinomycosis Benign
Mycobacterial infections[1] Benign Recent travel to endemic regions

Exposure to TB patients

- Matted cervical nodes

Firm

Non-tender

+
Staphylococcal or streptococcal infection Benign - - + + Gram stain: gram (+) cocci in clusters for Staph

Gram (+) cocci in chains for strep

Blood Culture: +

Parasitic lymphadenopathy Toxoplasma gondii[2][3] Benign 6 years and older adults are more affected in U.S.

Seen in Hot climates

Cats or birds feces exposure

Drinking unpasteurized milk

Undercooked food

Organ transplant recipients

+ - Bilateral

Non-tender

Symmetrical

Non-fluctuant

- + Serology : + IgG and IgM

antibodies

Follicular hyperplasia MRI:

Multiple rings enhanced lesions

Serology

Immunofluorescence

MRI

CT scan

Sarcoidosis[4][5] Benign More common in African American women aged 20 - 40 years. Family history of sarcodosis,

Fatigue, swelling and pain in the joints,

- - Bilateral

tender LAD

Swollen, non-tender parotid glands

Erythema nodosum,

Lupus pernios

+ ESR

ACE

Non-caseating granulomas involved in multiple organs. CXR: B/L hilar adenopathy

MRI: B/L multiples enlarged cervical lymph nodes

CT scan of chest

Biopsy

MRI

Heerfordt's syndrome: uveitis, facial nerve paralysis, parotitis
Amyloidosis + Biopsy
Sjögren syndrome Benign Female to male ratio: 9 to 1

May happen at any age

Mean age: 40-50

History of RA, SLE, and non-hodgkin B-cell lymphoma.

Dry mouth, dry eyes.

- + B/L enlarged parotid glands Itchy

Rashes

Dry

+ ESR

Anti-SSA/Ro

Anti-SSB/La

Cytopenia

Castleman disease (angiofollicular lymphoproliferative disease)
Kikuchi disease (histiocytic necrotizing lymphadenitis) +
Kimura disease
Rosai-Dorfman disease
Kawasaki disease Benign Rashes +
Category Diseases Benign or Malignant Demography History Pain Dysphagia Mass exam Skin changes LAP Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings
Neoplasm Primary thyroid tumor
Salivary gland neoplasm Pleomorphic adenoma +
Warthin's tumor +
Lymphoepithelioma +
Oncocytoma
Monomorphic adenoma
Mucoepidermoid carcinoma
Adenoid cystic carcinoma
Adenocarcinoma
Salivary duct carcinoma
Squamous cell carcinoma
Parathyroid tumors
Carotid body tumors
Paraganglioma
Schwannoma
Lymphoma
Liposarcoma
Lipoma
Glomus vagale, glomus jugulare tumors
Metastatic head and neck carcinoma
Other Hematoma
Arteriovenous fistula
Goiter
Category Diseases Benign Demography History Pain Dysphagia Mass exam Skin changes LAP Others Lab findings Histopathology Imaging Gold standard diagnosis Associated findings

References

  1. Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A (March 2014). "Peripheral lymphadenopathy: approach and diagnostic tools". Iran J Med Sci. 39 (2 Suppl): 158–70. PMC 3993046. PMID 24753638.
  2. Kumar GG, Mahadevan A, Guruprasad AS, Kovoor JM, Satishchandra P, Nath A, Ranga U, Shankar SK (June 2010). "Eccentric target sign in cerebral toxoplasmosis: neuropathological correlate to the imaging feature". J Magn Reson Imaging. 31 (6): 1469–72. doi:10.1002/jmri.22192. PMC 2908244. PMID 20512900.
  3. [+https://www.cdc.gov/parasites/toxoplasmosis/diagnosis.html "CDC - Toxoplasmosis - Diagnosis"] Check |url= value (help).
  4. "Sarcoidosis | National Heart, Lung, and Blood Institute (NHLBI)".
  5. Abdel Razek A, Mukherji S (June 2017). "Imaging of sialadenitis". Neuroradiol J. 30 (3): 205–215. doi:10.1177/1971400916682752. PMC 5480791. PMID 28059621. Vancouver style error: initials (help)