Dear collegues, we present a new article
Neck Masses in Children
by Annemieke Littooij, Cécile Ravesloot and Erik Beek
of the Radiology department of the University Medical Center Utrecht in the Netherlands
In this article we present a pictorial essay of neck masses in children and provide a diagnostic approach based on the location of the lesion and whether it is cystic or solid.
In a neck lesion in a child, ultrasound can usually determine whether a lesion is cystic or solid.
In cystic lesions the diagnosis can frequently be made based on the location of the lesion (see next figure).
- Lymph node
If the lesion is solid the next step is to assess whether it is a lymph node or something else.
Often more than one lymph node is enlarged. Try to differentiate between reactive nodes, lymphadenitis due to TB or cat-scratch disease and malignant lymphoma.
- Solid - not a lymph node
If a solid lesion is not a lymph node look for a possible site of origin, like the salivary gland, the thyroid gland or the sternocleidomastoid muscle.
Subcutaneous solid lesions sometimes have a typical appearance, like pilomatrixomas, lipomas or hemangiomas.
In many cases however a solid lesion will be non-specific and a diagnosis can only be made through biopsy or excision.
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Robin Smithuis and Otto van Delden (editors)