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Neck masses in children

Department of Radiology, Royal Belfast Hospital for Sick Children, 180 Falls Road, Belfast BT12 6BE, UK

View larger version (26K): [in a new window]   Figure 1. Anatomical diagram illustrating the anterior and posterior triangles of the neck.

View larger version (106K): [in a new window]   Figure 2. Thyroglossal cyst. (a) Ultrasound shows a midline hypoechoic, avascular mass (arrow). (b) Axial short tau inversion recovery MRI confirms a high signal, well defined cyst (arrow).

View larger version (89K): [in a new window]   Figure 3. (a) Ultrasound of an uncomplicated branchial cyst. Note the absence of septations and the through enhancement. (b) Axial contrast enhanced CT showing a right sided low attenuation branchial cyst.

View larger version (117K): [in a new window]   Figure 4. Axial T1 weighted MRI of a mixed signal, right sided teratoma (arrows). The low signal cystic components and the intermediate signal fat can be identified.

View larger version (63K): [in a new window]   Figure 5. (a) Isotope scan of thyroid demonstrating a photopenic area within the left lobe. (Reproduced with permission of Springer-Verlag [12]). (b) Axial contrast enhanced CT of the same patient shows a solid mass within left lobe of thyroid (arrows). Lymphoma was proven by biopsy.

View larger version (80K): [in a new window]   Figure 6. (a) Parotid ultrasound demonstrating multiple hypoechoic areas representing dilated ducts (reproduced with permission of Springer-Verlag [12]). (b) Sialogram of same patient confirming intraglandular ductal beading of sialectasis of the left parotid gland.

View larger version (106K): [in a new window]   Figure 7. (a) Ultrasound of a hypoechoic septated cystic hygroma. (b) Axial T2 weighted MRI of a well defined high signal right sided cystic hygroma (arrows). Note the insinuation around normal structures.

View larger version (144K): [in a new window]   Figure 8. Ultrasound of isoechoic mass (arrows) consistent with fibromatosis coli within the sternocleidomastoid muscle.

View larger version (102K): [in a new window]   Figure 9. (a) Lateral soft tissue neck radiograph of a haemangioma containing phleboliths (arrows). (b) Ultrasound demonstrating a soft tissue density mass with hypoechoic branching vascular channels. These were vascular on colour Doppler. (c) Axial T1 weighted MRI of a left sided, high signal haemangioma with vascular flow voids.

View larger version (157K): [in a new window]   Figure 10. Ultrasound of well defined hypoechoic enlarged lymph nodes (arrows).

View larger version (101K): [in a new window]   Figure 11. (a) Ultrasound of a mixed echogenic, thick walled, ill defined mass with central necrosis consistent with an abscess. (b) Radiograph showing extensive pre-vertebral soft tissue swelling of a retropharyngeal abscess (reproduced with permission of Springer-Verlag [12]).

View larger version (108K): [in a new window]   Figure 12. Axial contrast enhanced CT of an inhomogeneous, enhancing, left sided, soft tissue mass within the anterior triangle (arrows). Histological diagnosis was rhabdomyosarcoma.

View larger version (136K): [in a new window]   Figure 13. Axial contrast enhanced CT demonstrating an irregular, enhancing right sided, biopsy proven neuroblastoma.

View larger version (81K): [in a new window]   Figure 14. Axial contrast enhanced CT demonstrating multiple left sided lymph nodes and a right sided lymphomatous mass (arrows). Biopsy revealed Hodgkins lymphoma.