Pediatric neck masses: how clinical and radiological features can drive diagnosis
Pediatric neck masses are a common occurrence and often represent a diagnostic challenge. The primary aim of this retrospective study was to evaluate the clinical and radiological features of neck masses in children and how they can drive diagnosis. The secondary aim was to create a diagnostic algorithm based on clinical features. We evaluated 190 children with neck masses who needed hospitalization. Clinical data and imaging findings were collected. The patients were divided into six groups: congenital/developmental lesions, tumors, acute and subacute lymphadenopathies, chronic nonspecific lymphadenopathies, cat-scratch disease, and mycobacteriosis. Reactive lymphadenopathies were observed in the majority of cases (65.8%). Congenital/developmental cysts were present in 28.9%, while 5.3% had a tumor. A lower mean age was observed for acute/subacute lymphadenopathies and mycobacteriosis. Fever and a painful mass were typical of acute/subacute lymphadenopaties and cat-scratch disease. A hard and fixed mass was not only typical of tumors. Concerning imaging findings, multiple lymph nodes at the same level was mainly observed in mycobacteriosis, while bilateral lymph node enlargement and colliquation were present in lymphadenopathies.
What is Known:
• Pediatric neck masses are a common occurrence and often represent a diagnostic challenge.
• Clinical features, serological exams and imaging findings should drive the physician to an appropriate diagnostic hypothesis.
What is New:
• A lower mean age was observed for acute/subacute lymphadenopathies and mycobacteriosis.
• A hard and fixed mass was not only typical of tumors.
• Multiple lymph nodes at the same level were mainly observed in mycobacteriosis, while bilateral lymph node enlargement and colliquation were present in nonspecific lymphadenopathies.
KeywordsNeck mass Children Cysts Lymphadenopathy Pediatric tumors Cat-scratch disease
Analysis of variance
Periodic fever, aphthous stomatitis, pharyngitis, adenitis
Statistical Package for Social Sciences
Giuseppe Riva: data collection and analysis and writing of the manuscript. Matteo Sensini: data collection and analysis. Federica Peradotto: data collection and analysis. Carlo Scolfaro: review of the manuscript. Gianpaolo Di Rosa: review of the manuscript. Paolo Tavormina: review of the manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.
Informed consent was obtained from all individual participants included in the study.