Learning objectives
To illustrate the ultrasound (US) featuresof the most frequently encountered pediatricneck masses (inflammatory lymph-nodes,
parotitis,
hemangiomas,
lymphangiomas,
fibromatosis colli,
branchial cleft and thyroglossalcysts,
abscesses,
lymphoma) as well as some of the rare causes of neck swelling in children (myositis,
histiocytosis,
ectopic thyroid or thymus,neurofibroma,
teratoma).
To present a diagnostic approach for pediatric neck masses with focus on ultrasound as the first line imaging tool.
Background
Neck swelling in children represents a very frequent cause for presentation in pediatric units.
They may be congenital and acquired,
inflammatory or tumoral,
benign or malignant and they can arise from any neckstructuressuch as the commonlymph-nodes,
the salivary glands,
thyroid,
thymus,
muscles,
vascular structures and bones.
With these pathological and anatomical heterogeneity it may truly be a challengeto reach a diagnosis and decide on the proper treatment and therefore imaging is often required.
The first line of imaging is obviously represented by US since it...
Findings and procedure details
US is the method of choice when approaching pediatric neck masses and therefore this presentation will focus on the US examination and when necessary will make reference to MR or CT.
US examination technique
The patient is examined in a supine position with a pillow or the hand of the mother placed under the shoulders of the child in order to obtain proper head extension.
Since the targeted lesions are mainly superficial,
the examination is routinely performed with a linear transducer (7-14 MHz) to ensure...
Conclusion
Ultrasonography represents the first-line examination due to its excellent visualization and characterization of neck structures,
availability and lack of radiation.
It is able to establish the parenchymal or cystic nature of a mass and its vascularity pattern.
In certain situation,
mainly due to the large size of some lesions,
magnetic resonance (MRI) or computed tomography (CT) are necessary in order to establish the origin of amassor its extent.
MRI is preferred due to its superior conspicuity and delineation of lesions and anatomical structures and also...
References
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Neck masses in children,
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https://radiopaedia.org/articles/langerhans-cell-histiocytosis-skeletal-manifestations-1