ULTRASONOGRAPHY EVALUATION OF PEDIATRIC NECK MASSES

Abstract

Background: Neck masses are a frequent discovery in children and pose challenges in diagnosis. These masses can stem from congenital, inflammatory, neoplastic, or vascular origins. Understanding the cervical anatomy and compartments is crucial for differential diagnosis. There are different cystic lesions like ranula, thyroglossal cyst, brachial cyst, lymphangioma and vascular malformation and solid lesions like reactive lymph nodes,thyroid lesions,ectopic thymus etc.Rare lesions like teratoma,rhabdomyosarcoma,neurofibroma also exists. Aims: To assess congenital and acquired neck masses in children using ultrasonography (USG) and correlate imaging findings with pathology. Materials and Methods: This prospective observational study involved 30 pediatric patients with clinically palpable neck swellings referred for USG. Imaging was followed by necessary USG-guided procedures, and radiological findings were compared with histopathology. Results: Among 30 patients, 68% were male and 32% female. Most patients (53%) were aged 1-10 years. Right-sided lesions were most common (41.15%), with bilateral (17.25%) and midline (11.5%) presentations noted. Inflammatory causes were predominant (76.1%), followed by congenital (16.3%) and neoplastic (7.5%). USG revealed features such as reactive lymphadenitis (14 cases), TB lymphadenitis (6 cases), abscesses (2 cases, confirmed by aspiration), thyroglossal cysts (3 cases), lipomas (2 cases, confirmed by histopathology), malignancies (2 cases, confirmed by biopsy), and a branchial cyst (1 case). Conclusion: Pediatric neck masses are common and diagnostically challenging. Detailed clinical history, physical examination, and knowledge of cervical anatomy are crucial for accurate diagnosis. Utilizing neck compartments and multimodality imaging aids in precise diagnosis and appropriate management.