1. Cervical Swellings
A Compilation by Avinash Kande, Internee, Shalakya Dept.
G.A.M. & R.C.

2. 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.

3. Cervical Swellings :

4. 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.

5. A few swellings of the skin & superficial fascia may appear anywhere in midline like sebaceous cyst, lipoma, fibroma, neurofibroma & dermoid cyst.

6. B. Lateral Swellings :

7. 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.

8. Carotid Swellings : 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.

9. Posterior Swellings : 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

10. Swelling can also be as follows :

11. Chronic Swellings :

12. Acute Swelling : 1.Boil 2.Acute lymphadenitis 3.Ludwig’s angina
4.Curbuncle

13. Cystic Swellings : Branchial cyst Thyroglossal cyst Dermoid cyst
Cystic Hygroma
Sebaceous cyst
Cystic adenoma of thyroid gland
Cold abscess
Lymph node abscess
Plunging ranula
Pharyngeal pouch
Laryngocele
Retention cyst of salivary gland

14. Solid Swellings Swellings arising from Thyroid
Swellings arising from Salivary gland
Lymph node swellings
Branchiogenic carcinoma
Sternomastoid Tumour
Carotid body tumour
Cervical Rib

15. Pulsatile Swellings Carotid artery aneurysm Subclavian artery aneurysm
Carotid body tumour
Lymph node swellings close to carotid artery( transmitted pulsation)
Primary toxic goitres

16. 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.