Lumps and Bumps of the Neck in Children—Neuroimaging of Congenital and Acquired Lesions

Abstract

Neck masses present as palpable lumps and bumps in children with acquired lesions more common than congenital ones. Assessment of the anatomical site of origin, signal, and contrast enhancement characteristics may help define the etiology of the lesions, eg, developmental, inflammatory, vascular, or neoplastic. The age of the patient along with detailed clinical history and physical exam findings are important element to narrow down the differential diagnosis. The correct final diagnosis is essential to guide treatment as well as the urgency of intervention. The objective of this review is to define the characteristic location, classic and differentiating imaging features of the most frequent congenital and acquired cervical lumps and bumps in the pediatric population.

Congenital Cystic Neck Mass in a 2-Month-Old Infant

“…3,5 Branchial cleft cysts constitute approximately 20% of all excised pediatric cervical masses, following the failure of pharyngobranchial ducts to entirely obliterate during fetal development. 6 They present as tender, inflammatory masses along the anterior border of the sternocleidomastoid muscle much later in childhood than foregut duplication cysts. 6,7 Younger patients may present with fistulas between the cyst and external surface of the neck.…”

“…6 They present as tender, inflammatory masses along the anterior border of the sternocleidomastoid muscle much later in childhood than foregut duplication cysts. 6,7 Younger patients may present with fistulas between the cyst and external surface of the neck. On imaging, branchial cleft cysts are well-defined, thin-walled, and anechoic.…”

Cutaneous ultrasound and its utility in pediatric dermatology. Part I: Lumps, bumps, and inflammatory conditions

“…When visualized, blood vessels follow a hilar distribution. Reactive lymph nodes show an increase in size but maintain the features of a regular lymph node . Enlargement usually occurs inside the cortex, so the hypoechoic peripheral ring is thicker in inflammatory lymph nodes .…”

Infections of Congenital Neck Masses

“…Congenital masses of the head and neck already exist by the time the child is born, but they may pass unrecognised up to the point when they later cause a problem [1]. A child with a noticeable neck mass may present perinatally or in a paediatric general clinic.…”

“…There are specific patterns to the presentation, which are a result of the embryological development and anatomical configuration of this part of the body. Clinicians need to understand these subjects well to appreciate the varying natural historical features of particular masses [1][2][3][4].…”