Ct Evaluation Of Neck Masses- A Retrospective Study Of 100 Cases

BACKGROUND:Before advent of cross section imaging radiologists were of limited help in diagnosis of neck lesions, especially those involving deep neck spaces of suprahyoid neck (SHN). AIM:Aim of our study is to characterise neck lesion by its morphological characteristics and enhancement pattern, outlining the extent, assessment of lymphadenopathy, look for criteria for operability and histopathological confirmation. METHODS & MATERIALS:In this study 100 cases of neck masses were evaluated retrospectively in our department. The CTscan was performed prior to the treatment in all these patients. CTimaging feature includes location, size/diameter, degree & pattern of enhancement, intraluminal/exophytic, internal necrosis & hemorrhage, local spread, nodal & distant metastasis.RESULTS:Out of 100 patients studied 27% were benign and 73% were malignant neck lesions, overall there was a male preponderance with a male to female ratio of 2.1:1. Benign lesion were common in the age group of 16-45 yrs. while malignant lesions were more common in the elderly age group of >45 years. Most of the benign (26%) and malignant lesions (81%) showed heterogeneous enhancement pattern. Bone invasion seen in 15% benign lesions, 19% of malignant lesions and cartilage invasion seen in 7% of malignant lesions. On correlation with HPE, among malignant lesions most common was Squamous cell carcinoma (48%) and among benign lesions most common was nonspecific inflammation. The sensitivity and specificity of study is 95.7% & 77.5% respectively, with positive predictive value and negative predictive value of 90.4% & 88.9% respectively and Accuracy is 90%.

Adult Cystic Hygroma– A Rare Entity

Objective Lymphangiomas (Cystic Hygromas) are rare congenital malformations commonly seen in children. Its occurrence in adults is uncommon with very scarce reports in the literature. It mainly occurs in infants or children younger than 2 years of age. We report this case to emphasise the need to consider cystic hygroma in differential diagnosis of neck masses in adults. Case Reports A 50-year-old female presented with a swelling over the antero– lateral aspect of neck of size 8´6 cm since last 4 years, which was not associated with pain, discharge, discolouration or sudden increase in size. Conclusion The awareness of occurrence of cystic lymphangio main adults is important for its proper management, which includescomplete surgical removal, to prevent recurrence.

Application of liquid-based preparations in fine needle aspiration for identifying non-thyroid neck masses / 实用医学杂志

Objective To compare the value of liquid-based preparations versus conventional smears in the diagnosis of non-thyroid neck masses from fine needle aspiration. Methods The two different methods were compared by the smear quality and the diagnostic accuracy for the aspiration samples of non-thyroid neck masses of 400 patients. Results The unsatisfactory rate for LBP was lower than that for CS (13.0% vs. 16.0%, P < 0.05). The sensitivity was 94.6% for LBP and 92.9% for CS, and the accuracy was 96.8% for LBP and 95.0% for CS. In the aspect of smear quality, LBP had advantages of quantity of cells, with clear background and easily identifiable cell morphology. Conclusions LBP has more advantages than CS in the identification of non-thyroid neck masses, especially for cervical nodal enlargement. But it has no marked advantages in the diagnosis of salivary gland lesions.

Magnetic resonance imaging evaluation in the diagnosis of pediatric neck masses / 临床儿科杂志

Objectives To evaluate pediatric neck masses with magnetic resonance imaging (MRI). Methods In this retrospective study, 140 children with neck masses underwent MRI were collected from May 2006 to December 2013. Of them 34 cases went through pathological examinations. The results of MRI diagnosis and pathology were compared in 34 cases. Results In 140 children with neck masses diagnosed by MRI, 103 (73.6%) cases were benign lesions, including 62 vascular malformations, 30 hemangiomas, then cysts, hamartoma, infectious lumps etc., 29 (20.7%) were malignant tumors, including 22 lymphomas, 3 rhabdomyosarcomas, 3 Langerhans cell histiocytosis, 1 neuroblastoma, and 8 (5.7%) cases were undeter-mined masses. Four in 103 cases with benign lesions were performed by pathological examination and all had been con-firmed. Tewenty-five in 29 cases with malignant tumors were performed by pathological examination and 22 cases had been confirmed. Conclusion MRI can help to diagnose the pediatric neck masses and to guide the treatment and follow-up.

Quiste cervical como manifestaci¢n inicial de un microcarcinoma papilar de tiroides / Cervical cyst as the initial manifestation of papillary thyroid microcarcinoma

Las masas quísticas en cuello son usualmente benignas en pacientes jóvenes. Sin embargo, tumores malignos de la cabeza y el cuello pueden presentarse ocasionalmente con metástasis quística. Se presenta el caso de una paciente de 33 años asintomática con una masa cervical quística de gran tamaño con 1 año de evolución, que inicialmente fue manejada como un quiste branquial, en quien luego de estudios por imagen e hispatológicos se sospechó carcinoma papilar de tiroides. Este diagnóstico fue corroborado en el trans-operatorio y se trató con tiroidectomía total, disección ganglionar del comportamiento central y disección ganglionar radical modificada derecha. El diagnóstico definitivo en el espécimen quirúrgico fue de un microcarcinoma papilar de tiroides con metástasis ganglionares quísticas y posteriormente la paciente recibió terapia con yodo radioactivo...

Differential Diagnosis of Head and Neck Mass Lesions

For the differential diagnosis of head and neck mass lesions, the age and presenting locations should be the primary considerations. The characteristic patterns of age- and sitepredilection allow a diagnostic work-up and treatment plans for the patients with head and neck mass lesions. In children and young adults, the underlying causes are; inflammatory, congenital and developmental, and neoplastic masses in decreasing frequency. By contrast, neoplastic diseases are most frequent in the elderly. Because of the characteristic lymphatic spread patterns of head and neck diseases, the location of the mass in the cervical lymphatic nodal chain may be the key for the identification and differential diagnosis of the primary disease site. Besides, the evaluation of specific historical and physical findings is mandatory for the accurate diagnosis. When the signs of inflammation are associated, conservative treatment and observation is first considered. On the other hand, for persistent or progressively enlarging masses and those with suspicious findings of malignancy, surgical intervention should be considered.