Neck tumor

Introduction Inflammation, tumors, and deformities in the neck can be expressed as neck masses, which are more common in clinical practice, many of which are malignant tumors. Therefore, the differential diagnosis of neck mass is of great significance.

Cause

1, tumor

(1) Primary tumors: including lymphocytic sarcoma, reticulum sarcoma, Hodgkin's disease, and the like.

(2) metastatic malignant tumors: the primary lesions are mostly in the mouth, nasopharynx, thyroid, lung, mediastinum, breast, gastrointestinal tract and pancreas.

2, inflammation

Acute, chronic lymphadenitis, lymphatic tuberculosis, mumps, soft tissue purulent infection, etc.

3, congenital malformations

Thyroid gland cyst or hernia, thymic pharyngeal cyst or hernia, cystic lymphangioma, subcutaneous dermoid cyst.

an examination

Related inspection

Neck MRI immunopathological examination blood test

Mainly look at the location, shape, size, number of the mass, the color of the surface, the filling of the blood vessels around the mass, the effect of the active neck or swallowing on the mass. Apply a flat finger palm to check the size, number, shape, and mobility, hardness, smoothness, tenderness, and fluctuations or tremors of the mass. The relationship between the mass and surrounding tissues and large blood vessels. Malignant tumors are generally hard, fixed, and the surface is not smooth and has no tenderness. Inflammatory masses have obvious tenderness and increased white blood cells. Aneurysms have dilatant fluctuations and tremors that are smooth. The cavernous hemangioma is soft and the surface is uneven and pale blue. The cyst has a fluent, smooth, and pressurized pressure that does not shrink. The mass from the thyroid gland moves up and down with swallowing.

A neck mass, especially if it is suspected of metastatic cancer, should be examined in detail for the thyroid, mouth, and nasopharynx. Multiple lymph nodes are found in the neck, and the lymph nodes, liver and spleen should be examined. Lymph nodes in the supraclavicular fossa should be examined for organs such as the lungs, breasts, gastrointestinal tract, and pancreas. Acute inflammatory masses should be accompanied by systemic symptoms such as fever and pulse increase.

Laboratory inspection:

1, laboratory and X-ray examination: blood examination for the diagnosis of malignant lymphoma and inflammatory mass has a certain significance, chest X-ray film for the diagnosis of tuberculosis, lung cancer, mediastinal tumor is valuable, X-ray barium meal examination for gastrointestinal tumors Found to be helpful.

2, pathological examination: the diagnosis of neck mass is unknown, especially when suspected malignant tumor, can take the living tissue for pathological examination, in the removal of living tissue, in the case of tissue soft and lumps, should first make a diagnostic puncture, observe There is no blood outflow, so as not to cut the vascular mass and cause severe bleeding.

Differential diagnosis

1. Submandibular infraorbital area

Submandibular gland inflammation, subcutaneous dermoid cyst

2, the front of the neck area

Thyroid gland cyst and hernia, various thyroid diseases, parathyroid tumors

3, the neck area

(1) Single lumps

Lipoma, schwannomas, salivary gland tumors, thymus cysts and sputum, cystic lymphangioma, carotid body tumor, hemangioma, eosinophilic granuloma, lymph node metastasis of cancer, malignant lymphoma, localized acute, chronic lymph nodes Inflammation, lymph node tuberculosis

(2) multiple masses

Acute and chronic lymphadenitis, lymph node tuberculosis, malignant lymphoma, lymph node metastasis

4, the upper clavicle (zone)

Metastatic tumors (stomach cancer on the left, single or multiple, lung cancer, esophageal cancer, breast cancer, single or multiple) lymph node tuberculosis (unilateral often multiple)

5, the posterior neck area

Fibroids, lipomas (may also occur in other areas)

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