Otolaryngology Book

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Causes of Neck Mass in Adults

Aka: Causes of Neck Mass in Adults, Neck Mass Causes in Adults
  1. See Also
    1. Neck Masses in Adults
    2. Lymphadenopathy of the Head and Neck
    3. Lymphadenopathy
    4. Neck Masses in Children
  2. Causes: Acute (days to weeks)
    1. Common
      1. Most causes are reactive Lymphadenopathy
      2. Viral infection
        1. Epstein-Barr Virus (EBV)
        2. Cytomegalovirus (CMV)
        3. Upper Respiratory Infection
      3. Bacterial Infection
        1. Staphylococcal or Streptococcal infection of the head or neck
      4. Parasitic Infection
        1. Toxoplasmosis
    2. Uncommon
      1. Infection
        1. Acute Sialadenitis (or Sialolithiasis)
        2. Bartonella Henselae (Cat Scratch Disease)
        3. Acute HIV Infection
        4. Mycobacterium tuberculosis
      2. Trauma or vascular cause
        1. Hematoma
        2. Pseudoaneurysm
        3. Arteriovenous fistula
  3. Causes: Subacute (weeks to months)
    1. Common
      1. Squamous Cell Carcinoma of the Oropharynx
      2. Squamous Cell Carcinoma of the Tongue
      3. Squamous Cell Carcinoma of the Larynx
    2. Uncommon
      1. Lymphoma
      2. Metastatic cancer
      3. Salivary Gland Tumor (e.g. Parotid Tumor)
      4. Sarcoidosis
      5. Sjogren Syndrome
    3. Rare
      1. Castleman Disease (angiofollicular lymphoproliferative disease)
        1. Benign lymphoproliferative condition of mediastinum presenting with a single inflamed lymph node
      2. Kikuchi Disease (histiocytic necrotizing Lymphadenitis)
        1. Self limited (3 month course) of fever, posterior Lymphadenopathy and Leukopenia
      3. Kimura Disease
        1. Non-tender, idiopathic subcutaneous mass associated with Eosinophilia; endemic in Asia
      4. Rosai-Dorfman Disease
        1. Matted Lymphadenopathy with occasional fever in otherwise healthy adults
  4. Causes: Chronic (months to years)
    1. Common
      1. Thyroid mass (Thyroid Nodule, Graves Disease, Goiter)
    2. Uncommon (in adults)
      1. Lipoma
      2. Laryngocele
        1. Due to recurrent forceful nose blowing, coughing or wind instrument use
      3. Congenital Anomaly
        1. Branchial Cleft Cyst
        2. Thyroglossal Duct Cyst
      4. Parasympathetic tumors of the neck (Flushing, Palpitations, Hypertension with local affects)
        1. Carotid body tumor
        2. Glomus jugulare tumor
        3. Glomus vagale tumor
    3. Rare
      1. Liposarcoma
      2. Parathyroid cancer
  5. Causes: Malignant Adult Neck Masses
    1. Metastatic Squamous Cell Carcinoma
    2. Thyroid Cancer
    3. Lymphoma
    4. Salivary Gland cancer
    5. Sarcoma
  6. Causes: Benign Neck Masses in Adults
    1. Lymphadenopathy or Lymphadenitis
      1. See Lymphadenopathy of the Head and Neck
    2. Specific Infections
      1. Soft tissue neck abscess
      2. Tuberculosis or Atypical Mycobacterial infection
      3. Cat Scratch Disease
      4. Infectious Mononucleosis
    3. Vascular abnormalities
      1. Hemangioma
      2. Lymphangioma
    4. Soft tissue masses
      1. Paraganglioma
      2. Lipoma
      3. Neurofibroma
    5. ThyroidGoiter or other Thyroid mass
    6. Salivary Gland changes
      1. Parotid cyst
      2. Parotitis
      3. Sialolithiasis or Sialadenitis
      4. Sjogren Syndrome
    7. Congenital Anomaly
      1. Lateral neck
        1. Brachial cleft cyst
        2. Cystic Hygroma
        3. Dermoid
      2. Medial Neck
        1. Thyroglossal Duct Cyst
    8. Miscellaneous Conditions
      1. Sarcoidosis
      2. Gout or Pseudogout (rarely involves neck)
      3. Castleman Disease (angiofollicular lymphoproliferative disease)
        1. Benign lymphoproliferative condition of mediastinum presenting with a single inflamed lymph node
      4. Kikuchi Disease (histiocytic necrotizing Lymphadenitis)
        1. Self limited (3 month course) of fever, posterior Lymphadenopathy and Leukopenia
      5. Kimura Disease
        1. Non-tender, idiopathic subcutaneous mass associated with Eosinophilia; endemic in Asia
      6. Rosai-Dorfman Disease
        1. Matted Lymphadenopathy with occasional fever in otherwise healthy adults
  7. References
    1. Fedok in Noble (2001) Primary Care Medicine, p. 1767-73
    2. Haynes (2015) Am Fam Physician 91(10): 698-706 [PubMed]
    3. McGuirt (1999) Med Clin North Am 83(1):219-34 [PubMed]
    4. Schwetschenau (2002) Am Fam Physician 66(5):831-8 [PubMed]

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