NECK LUMPS CORE CONDITIONS SUMMARY
Condition Summary Epidemiology Pathophysiology Prognosis Aetiology Risk Factors S/S Investigations DDs Treatment Complications
Increase in normal Infection (head/ Infection: pain, quick Examine for extent,
Local or general lymphocyte/macrophage Good with neck); metastases; development, small size, soft size, site, fixation, Missed malignancy
Cervical swelling of cervical Infection; ALL/AML; Abx for infection;
response to an antigen; treatment; phenytoin use; and unfixed consistency, etc.; ENT diagnosis; cause-
lymph nodes due to Young children phenytoin use; lymphoma; biopsy; treatment
lymphadenopathy drainage from tongue, mortality varies lymphoma; Malignancy: painless, slow exam; CXR; FBC; ESR; related complication;
increased lymphatic young age infection for malignancy
ear, parotid, and deep with malignancy thyrotoxicosis; development, B symptoms, CRP; LDH; serology for lymphadenitis
drainage structures of the neck sarcoidosis larger size, hard and fixed infection; biopsy
Direct radiation
Older patients Direct radiation Slowly enlarging mass that is Sialolithiasis; Surgical excision/
Dependent on exposure; EBV; Post-operative
Tumour of the (peak at 40y/o) exposure; EBV; typically painless; malignancy FBC; U&Es; CRP; USS sialadenitis; neck dissection;
pathology, but smoking haematoma; facial
parotid gland Pleomorphic adenoma smoking (Warthin’s features (facial palsy, overlying with FNA; staging CT autoimmune post-surgical
Parotid tumour (largest of the (benign) 80%);
Dependent on pathology benign tumours
tumour); genetic
(Warthin’s
erythema/ulceration, pain); scan of the neck and disease; radiotherapy;
nerve damage; Frey’s
usually have tumour); genetic syndrome; salivary
salivary glands) mucoepidermoid carcinoma alterations (p53 dysphagia; hoarseness; airway thorax lymphoproliferative chemotherapy if
good outcomes alterations (p53 fistula
(malignant) 20%) mutation) obstruction disorders; HIV palliative
mutation)
Swelling of a Elderly
Benign or malignant Associated conditions Sialolithiasis;
salivary gland Stones account for 50%; Dependent on Surgical excision
neoplasm; ductal (neoplasm, sialolithiasis, ductal chronic sialadenitis;
(submandibular, increasing incidence, but pathology, but Hx of skin cancer; Bloods; USS with FNA; with post-operative Abscess; facial nerve
Salivary gland sublingual, or malignancy is rare; Dependent on pathology benign tumours stenosis; infection; previous head/ stenosis, infection, MRI; salivary ductal HIV; autoimmune radiotherapy; damage; salivary
swelling sialolithiasis; HIV; sialadenosis, etc.); red flag disease;
parotid); easily submandibular most usually have neck radiation imaging lithotripsy; anti- fistula; haematoma
Sjogren’s syndrome; symptoms (facial weakness, lymphoproliferative
missed as cervical commonly affected good outcomes inflammatories; Abx
sialadenosis rapid growth, ulcerations, etc.) disorders
lymphadenopathy M>F
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Condition Summary Epidemiology Pathophysiology Prognosis Aetiology Risk Factors S/S Investigations DDs Treatment Complications
Increase in normal Infection (head/ Infection: pain, quick Examine for extent,
Local or general lymphocyte/macrophage Good with neck); metastases; development, small size, soft size, site, fixation, Missed malignancy
Cervical swelling of cervical Infection; ALL/AML; Abx for infection;
response to an antigen; treatment; phenytoin use; and unfixed consistency, etc.; ENT diagnosis; cause-
lymph nodes due to Young children phenytoin use; lymphoma; biopsy; treatment
lymphadenopathy drainage from tongue, mortality varies lymphoma; Malignancy: painless, slow exam; CXR; FBC; ESR; related complication;
increased lymphatic young age infection for malignancy
ear, parotid, and deep with malignancy thyrotoxicosis; development, B symptoms, CRP; LDH; serology for lymphadenitis
drainage structures of the neck sarcoidosis larger size, hard and fixed infection; biopsy
Direct radiation
Older patients Direct radiation Slowly enlarging mass that is Sialolithiasis; Surgical excision/
Dependent on exposure; EBV; Post-operative
Tumour of the (peak at 40y/o) exposure; EBV; typically painless; malignancy FBC; U&Es; CRP; USS sialadenitis; neck dissection;
pathology, but smoking haematoma; facial
parotid gland Pleomorphic adenoma smoking (Warthin’s features (facial palsy, overlying with FNA; staging CT autoimmune post-surgical
Parotid tumour (largest of the (benign) 80%);
Dependent on pathology benign tumours
tumour); genetic
(Warthin’s
erythema/ulceration, pain); scan of the neck and disease; radiotherapy;
nerve damage; Frey’s
usually have tumour); genetic syndrome; salivary
salivary glands) mucoepidermoid carcinoma alterations (p53 dysphagia; hoarseness; airway thorax lymphoproliferative chemotherapy if
good outcomes alterations (p53 fistula
(malignant) 20%) mutation) obstruction disorders; HIV palliative
mutation)
Swelling of a Elderly
Benign or malignant Associated conditions Sialolithiasis;
salivary gland Stones account for 50%; Dependent on Surgical excision
neoplasm; ductal (neoplasm, sialolithiasis, ductal chronic sialadenitis;
(submandibular, increasing incidence, but pathology, but Hx of skin cancer; Bloods; USS with FNA; with post-operative Abscess; facial nerve
Salivary gland sublingual, or malignancy is rare; Dependent on pathology benign tumours stenosis; infection; previous head/ stenosis, infection, MRI; salivary ductal HIV; autoimmune radiotherapy; damage; salivary
swelling sialolithiasis; HIV; sialadenosis, etc.); red flag disease;
parotid); easily submandibular most usually have neck radiation imaging lithotripsy; anti- fistula; haematoma
Sjogren’s syndrome; symptoms (facial weakness, lymphoproliferative
missed as cervical commonly affected good outcomes inflammatories; Abx
sialadenosis rapid growth, ulcerations, etc.) disorders
lymphadenopathy M>F
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