Cervical lymphadenopathy in children

What it is

Cervical lymphadenopathy is swelling of the lymph nodes in the neck. It sits among the neck masses, which are grouped by where they lie: central neck masses, anterior triangle masses and posterior triangle masses. Submental lymphadenopathy is one of the central neck masses, next to the thyroglossal cyst, the thyroid mass and the cervical cleft.

The differential diagnosis of a neck mass is set out in four groups:

• Congenital: branchial cleft cyst, dermoid cyst, thyroglossal duct cyst, laryngocele, ectopic thyroid tissue.
• Neoplastic malignant: head and neck metastasis, thyroid, lymphoma, salivary gland tumor.
• Neoplastic benign: hemangioma, thyroid neoplasm or goiter, lymphangioma, salivary gland tumor, lipoma, carotid body tumor or paraganglioma.
• Systemic, inflammatory and infectious disease: lymphadenitis, bacterial or viral; deep neck abscess; cat scratch disease; tuberculosis or atypical mycobacterium; sarcoidosis, Kikuchi Fujimoto disease, Kimura disease, Castleman disease; sialadenitis.

Cervical lymphadenopathy is also one of the findings of a salivary gland tumor, and it is one of the suspicious ultrasound features of a malignant thyroid nodule, where enlarged abnormal lymph nodes with calcifications or cystic changes suggest metastatic disease. So an enlarged node is not always a node problem.