Learning objectives
- To review the differential diagnosis of non-cystic pediatric neck masses with cases to illustrate.
- To discuss a sytematic assessment of pediatric neck masses.
Background
Neck masses are a common finding and when they are non-nodal,
it can be a challenge to the radiologist.
The most common cause of a solid lesion is an enlarged lymph node but masses may have a congenital,
inflammatory,
neoplastic or vascular origin (Table 1).
Many are asymptomatic and detected on physical examination whereas others cause significant mass effect,
compromise of the aerodigestive tract or symptons.
Clinical history and physical examination are important clues but knowledge of the anatomy and embryology is essential to the...
Findings and procedure details
The evaluation of a pediatric patient usually begins with gray-scale and Doppler ultrasound (US).
US confirms the cystic or solid nature of the superficial masses and helps define their size and extent.
Color Doppler US may demonstrate the vascularization of the mass.
Deeply located masses are more difficult to access so computed tomography (CT) has an important role.
CT also allows the morphologic characterization and staging and precise visualization of bone strutuctures and calcifications. MRI offers superior contrast resolution in evaluating masses but usually requires...
Conclusion
Pediatric neck masses are a common finding and may be a diagnostic challenge.
Clinical history and physical examination are important clues as also knowledge of the anatomy and embryology of the cervical region.
The radiologist must be aware of age,
location and composition of a pediatric neck mass to make an appropriate evaluation.
An underlying syndrome alert to certain diagnosis.
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Imaging neck masses in the neonate and young infant.
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Common pediatric head and neck congenital/developmental anomalies.
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Pilomatricoma:...