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The mass in the neck.

A cervical mass should be approached in a systematic manner with a full knowledge of the possible etiologies and their consequences. The approach taken with a child differs markedly from that taken with an adult. Cervical masses in children are likely to be congenital or inflammatory. In adults, neoplastic masses are most common; most of these are metastatic. Indirect laryngoscopy, important in the search for the primary lesion, should be performed on all patients.

Adult↗

[Fine needle aspiration of neck tumor. Application of cytological, bacteriological and hormonal examinations].

Aspiration of neck tumors with a fine needle combined with cytological, bacteriological and hormonal examinations greatly improved the accuracy of the differential diagnosis of the neck tumors. Fine needle aspiration cytology in 45 patients with thyroid tumor gave only 4% (1/25) false negative diagnosis and 0% (0/20) false positive diagnosis for carcinoma, whereas false negative and false positive diagnosis by palpation were 34% and 4%, respectively and those by soft tissue roentgenogram were 55% and 0%, respectively. Differential diagnosis of histological types of thyroid carcinoma was possible by cytology. Fine needle aspiration of cervical lymph nodes gave the diagnosis of malignant lymphoma, metastatic squamous cell carcinoma, adenocarcinoma or inflammatory changes. Bacterial culture from the aspirate yielded causative microorganism in 5 patients including 4 with tuberculosis. The specimens aspirated from thyroglossal duct cysts or branchial cysts showed specific appearance and cytological feature. The aspirate from a parathyroid cyst was watery clear and contained high amount of parathyroid hormone. Dark brown serous aspirate from extrathyroidal mass suggested metastatic lesion from occult papillary carcinoma of the thyroid in 2 patients. Demonstration of very high content of thyroglobulin of the aspirate determined by radioimmunoassay supported the diagnosis, which was confirmed later at surgery. This method has become a routine work in our out-patient clinic.

Adenocarcinoma↗

CT of the soft tissue structures of the neck.

CT is an excellent means of evaluating patients with neck masses. It has the capability of defining the precise location of a mass and its effect on adjacent structures. The information obtained on CT may be used to determine the best possible approach for biopsy or surgery and to determine radiation therapy ports.

Bacterial Infections↗

Thyroglossal duct remnant carcinoma.

Thyroglossal duct remnant carcinoma is a very rare malignancy arising from aberrant thyroid tissue. This diagnosis, however, should be considered in patients presenting with anterior neck masses. If there is no invasion of the capsule of the tumor, local excision with diligent follow-up is recommended as the treatment of choice.

Adenocarcinoma↗