TY - CHAP M1 - Book, Section TI - Diseases Presenting as Neck Masses A1 - Kozin, Elliott D. A1 - Lustig, Lawrence R. A2 - Papadakis, Maxine A. A2 - McPhee, Stephen J. A2 - Rabow, Michael W. A2 - McQuaid, Kenneth R. PY - 2023 T2 - Current Medical Diagnosis & Treatment 2023 AB - The differential diagnosis of neck masses is heavily dependent on the location in the neck, the age of the patient, and the presence of associated disease processes. Rapid growth and tenderness suggest an inflammatory process, while firm, painless, and slowly enlarging masses are often neoplastic. In young adults, most neck masses are benign (branchial cleft cyst, thyroglossal duct cyst, reactive lymphadenitis), although malignancy should always be considered (lymphoma, metastatic thyroid carcinoma). Lymphadenopathy is common in HIV-positive persons, but a growing or dominant mass may well represent lymphoma. In adults over age 40, cancer is the most common cause of persistent neck mass and should be definitively ruled out. A metastasis from squamous cell carcinoma arising within the mouth, pharynx, larynx, or upper esophagus should be suspected. Risk factors for squamous cell carcinoma include smoking and HPV exposure. Especially among patients younger than 30 or older than 70, lymphoma also should be considered. In all cases, a comprehensive otolaryngologic examination is needed. Imaging and pathologic evaluation of the neck mass via FNA biopsy is likely to be the next step if a primary tumor is not obvious on physical examination. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/24 UR - accessmedicine.mhmedical.com/content.aspx?aid=1193145627 ER -