颈部肿块是初级保健服务的常见表现。在文献中对颈后肿块的病因研究甚少,因此仍然是患者和临床医生关注的问题。这通常会导致超声评估的紧急转诊。这项研究的作者试图从放射学的角度评估后颈肿块的病因,为了评估超声是否可以用作有用的辅助手段,而不是一线紧急调查.
■进行了回顾性病例系列研究,检查所有初级保健参考超声研究,以评估颈部后肿块,在埃塞克斯的一个机构演出,英国,在2012年2月2日至2022年11月8日期间超过10年。收集了以下数据:研究时的患者年龄,患者性,无论肿块是单发还是多发,由初级保健医生触诊和记录,肿块的大小最接近0.5厘米,如使用最长尺寸的超声记录,超声诊断和任何后续成像(不限于超声)。
■共对615名成年人进行了623次颈部超声检查。在623次扫描的总体放射学诊断中,555(89.09%)扫描为良性,63次(10.11%)扫描在超声检查中没有发现肿块,和3(0.48%)扫描显示恶性肿瘤。在剩下的2次(0.32%)扫描中,肿块被认为是不确定的。良性肿块最常见的病因是:正常淋巴结(n=263;42.21%),脂肪瘤(n=152;24.39%),良性真皮囊肿(n=105;16.85%)。3例恶性肿瘤均有颈前后肿块并存。
■鉴于我们研究中绝大多数的后颈肿块都是良性的,我们建议仅有单发或甚至多发后颈肿块的患者,无论大小,都可以进行常规检查,也可以根据其他临床检查特征进行确认.存在并存的前后颈部可触及的颈部肿块的患者,可以进行紧急或2周的等待放射学检查。
UNASSIGNED: Neck lumps are a common presentation to primary care services. The aetiology of
posterior neck lumps is poorly explored in the literature, and therefore remain a concern to patients and clinicians. This often results in an urgent referral for ultrasound assessment. The authors of this study sought to evaluate the aetiology of
posterior neck lumps from a radiological perspective, to assess whether ultrasound can be used as a useful adjunct, rather than a first-line urgent investigation.
UNASSIGNED: A retrospective case series was carried out, examining all primary care referred ultrasound studies for assessment of posterior neck lumps, performed at a single institution in Essex, United Kingdom, over a period of over 10 years dating between 2nd February 2012 to 8th November 2022. Data was collected on: patient age at the time of study, patient sex, whether the lump was single or multiple as palpated and documented by the primary care physician, size of the lump to the nearest 0.5 cm as documented on ultrasound using the longest dimension, sonographic diagnosis and any follow up imaging (not limited to ultrasound).
UNASSIGNED: A total of 623 neck ultrasounds were performed on 615 adults. Of the overall radiological diagnoses made from the 623 scans, 555 (89.09%) scans were benign, 63 (10.11%) scans had no lump found on sonography, and 3 (0.48%) scans showed malignancy. In the remaining 2 (0.32%) scans, the lump was deemed indeterminate. The most common aetiologies for benign lumps were due to: normal lymph nodes (n = 263; 42.21%), lipomas (n = 152; 24.39%), and benign dermal cysts (n = 105; 16.85%). All 3 malignant cases had co-existing anterior and
posterior neck lumps.
UNASSIGNED: Given that the overwhelming majority of
posterior neck lumps in our study had benign findings, we propose that patients with solitary or even multiple
posterior neck lumps alone, regardless of size can either be investigated routinely or can be reassured depending on other clinical examination characteristics. Patients who have the presence of co-existing anterior and posterior neck palpable neck lumps justifies urgent or 2-week wait radiological investigation.