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Paediatric neck masses--a diagnostic dilemma
1Department of Otolaryngology-Head and Neck Surgery, Glasgow Royal Infirmary, UK.
The Journal of Laryngology and Otology
|June 1, 1997
Summary
This study analyzed 360 pediatric head and neck masses, finding benign lesions like pilomatrixomata and thyroglossal cysts most common. Clinical diagnosis showed high accuracy for benign masses but was less reliable for lymph node content.
Area of Science:
- Pediatric Surgery
- Head and Neck Pathology
- Diagnostic Cytology
Background:
- Head and neck masses are common in children.
- Accurate diagnosis is crucial for appropriate management and reducing morbidity.
- Previous studies highlight the diversity of pediatric head and neck lesions.
Purpose of the Study:
- To review the types and frequency of pediatric head and neck masses excised.
- To evaluate the diagnostic accuracy of clinical assessment compared to histopathology.
- To assess the time to excision and inpatient stay for these masses.
Main Methods:
- Retrospective analysis of 360 pediatric patients undergoing mass excision.
- Data collection on patient demographics, lesion type, clinical diagnosis, and histopathology.
- Comparison of clinical diagnosis with histopathological findings.
Main Results:
- Benign lesions, including pilomatrixomata/sebaceous cysts (34%) and thyroglossal cysts (13%), were most frequent.
- Lymphadenopathy comprised reactive hyperplasia (60%), Mycobacterium infection (21%), and lymphomas (12%).
- High diagnostic accuracy (90-100%) for benign non-lymph node masses and tumors; lower for lymph node content (66%).
Conclusions:
- Pilomatrixomata and thyroglossal cysts are common pediatric head and neck masses.
- Clinical diagnosis is reliable for benign masses but less so for lymph node pathologies.
- Fine needle aspiration cytology may improve diagnostic accuracy and reduce patient morbidity.