Cervical Swellings
• A Compilation by
Avinash Kande,
Internee, Shalakya
Dept.
• G.A.M. & R.C.
Swelling:
• Swelling is a vague term which denotes
any enlargement or protuberance in the
body and may include tumors.
• According to cause, a swelling may be
congenital, traumatic, inflammatory,
neoplastic or miscellaneous.
Cervical Swellings :
Cervical Swellings
A. Midline Swellings
B. Lateral Swellings
A. Midline Swellings :
• 1.Thyroglossal cyst – chronic,
hard cystic swelling of
thyroglossal tract. The cyst moves
up with protrusion of tongue.
• 2.Ludwig’s angina – acute,
midline swelling
• 3.Subhyoid Bursitis –
inflammatory enlargement of
subhyoid bursa. pain with
swelling in the midline, does not
move with protrusion of tongue
• 4.Retrosternal Goitre – dyspnoea,
dysphagia both as pressure
symptoms with enlargement of
neck veins, may turn malignant.
• 5.Sublingual Dermoid –
congenital painless swelling under
the tongue.
• A few swellings of the
skin & superficial
fascia may appear
anywhere in midline
like sebaceous cyst,
lipoma, fibroma,
neurofibroma &
dermoid cyst.
B. Lateral Swellings :
Lateral Swellings
Submandibular
Carotid
Posterior
Submandibular Swellings
• 1.Enlarged lymph nodes
• 2.Submandibular salivary
gland enlargement – swelling
may turn painful with formation
of salivary stones, mostly in
Wharton’s duct.
• 3.Deep or plunging ranula – a
brilliantly translucent swelling
with cervical prolongation
• 4.Abnormal growth of jaw
• 5.Sjoren’s Syndrome – dry
eyes, dry mouth, rheumatoid
arthritis.
Carotid Swellings :
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1.Aneurysm of carotid artery
2.Carotid body tumour – called potato tumour
due to it’s consistency, slow growing painless
swelling at common carotid bifurcation moves
sideways never vertical, strong family history.
3.Branchial Cyst – painless swelling in upper &
lateral part of neck, painful if infected.
4.Branchiogenic carcinoma – rare tumour,
commoner in males, situated deep in neck.
Infiltrates surrounding structures causing
metastasis
5.Lymph node swelling
6.Sternomastiod tumour in new born –
torticolis, pain may be present, presence of
squint, regional lymph are not enlarged.
7.Laryngocele – occupational history important,
swelling moves up with larynx on swalllowing.
Posterior Swellings :
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1.Enlarged supraclavicular
lymph nodes.
2.Cystic Hygroma – cystic
swelling in posterior triangle of
neck.fluctuation test positive.
3.Phayrngeal pouch – old age,
diverticulum in pharynx in
posterior triangle, swelling is
fixed.
4.Subclavical aneurysm
5.Lipoma
6.Cervical rib – palpable lump in
subclavian triangle, numbness,
pain radiates from neck to
upper arm & forearm
7.Clavicular tumours
8.Cold abscess
Swelling can also be as follows :
Swelling
Acute
Chronic
Chronic Swellings :
Chronic Swellings
Cystic Swellings
Solid Swellings
Pulsatile Swellings
Acute Swelling :
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1.Boil
2.Acute lymphadenitis
3.Ludwig’s angina
4.Curbuncle
Cystic Swellings :
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Branchial cyst
Thyroglossal cyst
Dermoid cyst
Cystic Hygroma
Sebaceous cyst
Cystic adenoma of
thyroid gland
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Cold abscess
Lymph node abscess
Plunging ranula
Pharyngeal pouch
Laryngocele
Retention cyst of
salivary gland
Solid Swellings
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Swellings arising from Thyroid
Swellings arising from Salivary gland
Lymph node swellings
Branchiogenic carcinoma
Sternomastoid Tumour
Carotid body tumour
Cervical Rib
Pulsatile Swellings
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Carotid artery aneurysm
Subclavian artery aneurysm
Carotid body tumour
Lymph node swellings close to carotid
artery( transmitted pulsation)
• Primary toxic goitres
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Swellings which move up with deglutition are :
1.Thyroid swellings
2.Ectopic thyroid
3.Thyroglossal cyst
4.Subhyoid bursal cyst or subhyoid bursitis
5.Enlarged pretracheal lymph nodes, fixed to trachea
6.Laryngocele
• Only Thyroglossal cyst moves up also with protrusion of
tongue.