Neck swelling DDx

Neck swelling – Differential Diagnosis

Common causes

• Lymph nodes
• Goitre
• Thyroid lumps
• Thyroglossal cyst
• Sebaceous cyst
• Lipoma
• Branchial cyst

Must Not Miss

• Carotid aneurysm
• Malignancy
  • Lymphoma
  • Metastases
  • Thyroid cancer
• TB Lymphadenopathy

Easily missed

• Cervical rib
• Pharyngeal pouch
• Sarcoidosis

Red flags

• Hard fixed mass
• Persistent unexplained swellings > 3 weeks
• Persistent sore throat > 3weeks
• Persistent mouth ulcers
• Red and white patches of the oral mucosa
• Hoarse voice
• Dysphagia
• Persistent lymphadenopathy
• Thyroid nodule
• Systemic symptoms
  • (fever, night sweats, malaise, weight loss)

Investigations to consider

• FBC, CRP/ ESR
• Glandular fever screen
• TFTs
• Viral serology
• HIV screen
• Mantoux test
• CXR
• USS
• CT scan
• FNAC/biopsy
• Barium swallow
• OGD