DOI: http://dx.doi.org/10.18203/2349-2902.isj20195418

Clinical study and management of non-thyroidal neck swellings

Virendra Athavale, Sree Kumar Balasubramanian, Trupti Tonape, Shivamurti Khandalkar, Keerti Ramesh, Jyotsna Gogineni

Abstract


Background: Swellings in the neck are common and are encountered frequently in General Surgery. A diagnosis may be possible based on clinical examination alone but, investigations are required to clarify the diagnosis and, to exclude a diagnosis of malignancy. With this background, the present study is conducted in an effort to find out the causes for non-thyroidal neck swellings, and to assess the various investigations and management available for treating these neck swellings.

Methods: The study was conducted on newly diagnosed non thyroidal neck swelling cases coming to the Dept. of General Surgery, ENT, Oro- Maxillofacial and Pulmonary Medicine (OPD and IPD), Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune. The study was conducted from July 2017 to July 2019. Data collection included history taking, clinical examination, and radiological investigation and histopathological examination by specific pathologist throughout the study. After confirmation of diagnosis, patients were subjected to further management.

Results: Among 100 patients, male to female ratio was 1:1. The Mean age of the participants is 40.41±12.85 years. There was statistically significant association between tobacco addiction and malignant neck swelling. Considering HPE as gold standard, the sensitivity and specificity of fine needle aspiration cytology (FNAC) diagnosis is 81.8% and 100% respectively.

Conclusions: The overwhelming amount of possible diseases linked to a swelling in the neck, makes it of utmost importance to follow a strict protocol for appropriate diagnosis making and prompt treatment so as to prevent diagnostic delay. 


Keywords


Non-thyroidal neck swellings, Benign, Malignant, FNAC

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References


Balm AJ, van Velthuysen ML, Hoebers FJ, Vogel WV, van den Brekel MW. Diagnosis and treatment of a neck node swelling suspicious for a malignancy: an algorithmic approach. Int J Surg Oncol. 2010;2010.

Ahmad T, Naeem M, Ahmad S, Samad A, Nasir A. Fine Needle Aspiration Cytology (FNAC) and Neck Swellings in The Surgical Outpatient. J Ayub Med Coll Abbottabad. 2008;20(3):30-2.

Rao YN, Gupta S, Agarwal SP. National Cancer Control Programme: Current Status and Strategies. Agarwal SP, ed. Fifty Years of Cancer Control In India. Dir. Gen. of Health Services, MOHFW, Government of India, 2002: 41-47.

Popat CV, Vora D, Shah H. Clinico-pathological correlation of neck lesions – A study of 103 cases. Int J Head Neck Surg. 2010;4(2).

Mehrotra R, Singh M, Kumar D, Pandey AN, Gupta RK, Sinha US. Age specific incidence rate and pathological spectrum of oral cancer in Allahabad. Indian J Med Sci. 2003;57:400-4.

Rahman MA, Biswas MMA, Sikder AM. Scenario of fine needle aspiration cytology of neck masses in a tertiary care hospital. J Enam Med Col. 2011;1(1):8-14.

Shah JP, Patel SG, Singh B. Jatin Shah's Head and Neck Surgery and Oncology E- Book. Elsevier Health Sciences; 2012.

Koischwitz D, Gritzmann N. Ultrasound of the neck. Radiol Clin North Am. 2000;38:1029-104.

Gamba PG, Messineo A, Antoniello LM, Boccato P, Blandamura S, Cecchetto G, et al. A simple exam to screen superficial masses:fineneedle aspiration cytology. Med Pediatr Oncol. 1995;24(2):97-9.

Burnand KG, Young AE, Lucas J, Rolands BJ, Scholefield J. The new Aird‘s companion in surgical studies. 3rd edition. China: Elsevier;2005.

Muddegowda PH, Srinivasan S, Lingegowda JB, Kurpad R, Murthy KS. Spectrum of cytology of neck lesions:comparative study from two centers. J Clin Diagnos Res. 2014;8(3):44.

Karthikeyan CRM, Venkateswaran SR, Elangovan M. Clinical evaluation of nonthyroidal neck swellings. IAIM. 2019;6(6):57-61.

Ozdas T, Ozcan KM, Ozdogan F, Cetin MA, Dere H. The Correlation Between Clinical Prediagnosis and PathologyResults in the Diagnosis of Neck Masses. Indian J Otolaryngol Head Neck Surg 2014;66(3):237–40.

Biswas PK, Begum SMKN. Non-thyroid Neoplastic Neck Swelling Clinical and Histopathological Evaluation. The Journal of Teachers Association RMC, Rajshahi TAJ. 2008;21(2):152-4.

Bhattacharyya N. Predictive factors for neoplasia and malignancy in a neck mass. Arch Otolaryngol Head Neck Surg. 1999;125:303-7.

Alam K, Khan R, Jain A, Maheshwari V, Agrawal S, Chana RS, et al. The value of fine-needle aspiration cytology in the evaluation of pediatric head and neck tumors. Int J Pediatr Otorhinolaryngol. 2009;73(7):923-7.

Deshpande AV, Pothare AN. The clinical study and management of lateral neck masses. Int Surg J. 2017;4:1071-7.

Rastogi A, Sharma K, Gauba N. An evaluation of the efficacy of ultrasound in the diagnosis of neck swellings. Int J Otorhinolaryngol Head Neck Surg. 2018;4(1):169-75.

Lau SK, Wei WI. Efficacy of FNAC in diagnosis of tuberculous lymphadenopathy. J Lyngo-otology. 1990;104(1):24-7.

Nada A, Alwan AH. Cytopathology, FNAC versus histopathology in diagnosis of lymph node lesions of neck. Indian J Med Paediatr Oncol. 2012;2(42):320-5.

Merrik Z, Shoeman H, Vundule C, Lombard CJ, Tatley M. Randomized controlled trial of self supervised and DOT’s regime of tuberculosis. Lancet. 1998;352(24):1340-3.

Jones, Campbell. Tubercular lymphadenitis in childhood: The significance of anonymus mycobacteria. Br J Surg. 1963;50:302.

Dowell KE, Armstrong DM, Aust JB, Cruz AB.. Systemic chemotherapy of advanced head and neck malignencies. Cancer. 1975;35(4):1116-20.

Endicott JN, Cantrell RW, Kelly JH, Neel HB, Saskin GA, Zajtchuk JT. Head and neck surgery and cancer in aging patients. Otolaryngol Head Neck Surg. 1989;100(4):290-1.