other neck pathology

cervical lymphadenopathy

enlargement of the cervical lymph nodes

normal measurement of lymph nodes:

less than 1 cm

sonographic appearance of normal lymph nodes:

typically oblong-shaped hypoechoic structures with a distinguishable echogenic hilum

abnormal lymph nodes can result from:

• infection

• malignancy

clinical findings of abnormal lymph nodes:

• palpable neck mass → possibly

• enlarged nodes may be painful

sonographic findings of abnormal lymph nodes:

• enlargement of the node greater than 1 cm

• rounded shape

• loss of echogenic hilum

• calcifications

• may be hyperemic or demonstrate abnormal vascular patterns with color doppler

thyroglossal duct cysts

benign congenital cysts located within the midline of the neck superior to the thyroid gland and are typically located below the level of the hyoid bone

clinical findings of a thyroglossal duct cyst:

• palpable mass within the midline of the neck superior to the thyroid gland

• infected cysts may be painful

sonographic findings of a thyroglossal cyst:

• anechoic, well-defined, and unilocular cyst with posterior enhancement

• may have internal components

brachial cleft cysts

• congenital neck cysts that result from the maldevelopment of the brachial apparatus and brachial clefts in utero

• found most often near the angle of the mandible, but may occur in the lower, lateral neck

• a brachial cleft fistula can also occur in the same region and may allow fluid to leak to the skin surface

clinical findings of a brachial cleft cyst:

• palpable neck mass located near the angle of the mandible

• infected cysts may be painful

sonographic findings of a brachial cleft cyst:

anechoic mass near the angle of the mandible

fibromatosis colli

rare, pediatric fibrous tumor located within the sternocleidomastoid muscle

what may cause fibromatosis colli?

it is speculated that perhaps malposition in utero or a traumatic birth can lead to the development of fibrosis

clinical findings of fibromatosis colli:

• pediatric palpable neck mass

• torticollis → twisted neck with the chin angled to the nonaffected side

sonographic findings of fibromatosis colli:

• fusiform-shaped mass within the sternocleidomastoid muscle that is hypoechoic, hyperechoic, or even isoechoic to the adjacent tissue

• may also contain calcifications that shadow

• may yield a hyperemic pattern with color doppler

lymphangioma/cystic hygroma

• typically found in the posterior neck in utero or in the neonatal period

• consist of a buildup of lymphatic fluid

clinical findings of a lymphangioma:

• pediatric palpable neck mass

• asymptomatic or painful due to hemorrhage

sonographic findings of a lymphangioma:

thin-walled, hypoechoic or anechoic, septated mass