Neck swellings

Midline swellings

Solid Cystic
1. Lymph nodes 1. Thyroglossal cyst
2. Nodule of the thyroid isthmus 2. Dermoid cyst
3. Subhyoid bursitis
4. Plunging ranula
5. Laryngocoele
6. TB cold abscess

Subhyoid bursitis
Rare
Tender oval swelling below the hyoid bone that moves up and down with deglutition and protrusion of the
tongue.

Ranula
Definition: retention cyst of the sublingual salivary glands

Pathology:
Macroscopic: distended bluish cyst in the floor of the mouth filled with gelatinous material, if it extends
down in the neck over the posterior margin of the mylohyoid muscle it’s called plunging ranula that appears
in the neck as a midline swelling.
Microscopic: the wall is formed of a fibrous capsule lined by macrophages.

Clinical features
c/o: Swelling in the floor of the mouth. Midline neck swelling if plunging ranula is present.
o/e: mac..
treatment: excision (marsipulisation)

Laryngocoele
herniation of the laryngeal mucosa through the thyrohoid membrane.
Incidence: occurs in musician (blowing flutes)

Clinical features
Symptoms: swelling in the midline of the neck that  by blowing
Signs: cystic swelling in the midline of the neck, compressible, resonant and  in size by blowing.
 Submandibular triangle swellings

Solid Cystic
Submandibular salivary gland
Submandibular lymph nodes

Carotid triangle swellings

Solid Cystic
Cervical lymph nodes Branchial cyst
Enlarged thyroid lobe TB old abscess
Carotid body tumor Sternomastoid pseudo tumor
Carotid artery aneurysm

Carotid body tumor

Definition: Rare slowly growing tumor of the chemoreceptors at the bifurcation of the carotid artery.

Clinical features
c/o: Painless slowly growing swelling in the lateral side of the neck.
o/e: Single, painless swelling in the carotid triangle, smooth or lobulated, firm, transmitting the carotid
pulsations, not compressible, moves transversely but not up and down. No bruit on auscultation.
Investigations: angio
Treatment: excision with preservation of internal carotid artery.

Posterior triangle swellings

Solid Cystic
Cervical lymph nodes Cold abscess
Cervical rib Cystic hygroma
Neurofibroma Pharyngocoele
Pneumatocoele
Subclavian artery aneurysm
Pneumatocoele
Herniation of the pleura in the base of the neck
Cystic swelling in the supraclavicualr region cystic and compressible.

Other skin swellings that may arise anywhere in the body

Lipoma Sebaceous cyst Hemangioma