E1086. Move Over Thyroid Gland: Imaging Spectrum of Other Anterolateral Neck Masses
Authors
Sean Gharai;
George Washington University Hospital
Naiya Patel;
George Washington University Hospital
Joanna Riess;
George Washington University Hospital
Kathleen Brindle;
George Washington University Hospital
Nadia Khati;
George Washington University Hospital
Background
Neck masses are frequently encountered clinically and can be a diagnostic challenge, as they often have nonspecific clinical presentations. Patients may present with a palpable mass, neck swelling, dry mouth or symptoms related to compression of adjacent structures such as dysphagia or difficulty breathing. The differential diagnosis of anterior and lateral neck masses includes congenital and acquired entities which may be inflammatory, infectious, and neoplastic in etiology. Understanding the normal cervical anatomy is crucial to establishing a differential diagnosis and providing a logical diagnostic approach for classification. Diagnostic imaging includes various modalities essential to characterize these masses and their relationship to anatomic structures in order to make the diagnosis. Furthermore, imaging can be used to guide fine needle aspirations or core biopsies.
Educational Goals / Teaching Points
Ultrasound is typically used for initial evaluation given its wide availability, low cost and lack of ionizing radiation. Ultrasound helps confirm the presence of an abnormality, identify the location, nature, size, and extent of a neck mass while demonstrating its relationship to surrounding structures. Computed tomography (CT) or magnetic resonance imaging (MRI) are sometimes needed for more complex cases, to aid/and confirm the diagnosis. The purpose of this educational exhibit is to showcase various case-based examples of anterolateral neck masses excluding the thyroid gland, and their imaging manifestations across different imaging modalities.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Review important anatomic structures in the anterolateral neck. Discuss the differential diagnosis of neck masses including major salivary gland pathologies, congenital midline abnormalities such as thyroglossal duct cysts and ectopic thyroid tissue, parathyroid gland hyperplasia and masses, soft tissue neck masses and lymphadenopathy. Illustrate key sonographic imaging manifestations of various neck masses, as well as their CT and MRI correlations when indicated.
Conclusion
Neck masses encompass a wide spectrum of pathologies in adults. A better understanding of the cervical anatomy and imaging manifestations of commonly encountered nonthyroid neck masses is key to making an accurate diagnosis, guiding appropriate management such as surgical planning and improving patient care.
