![]() ![]() A TGDC may enlarge, become infected or even turn cancerous. An ultrasound scan usually confirms the diagnosis and will also ensure that you have a normal thyroid gland. These thyroglossal duct cysts (TGDCs) may present in childhood or early adulthood as a central neck lump that characteristically moves up when poking the tongue out. Occasionally, parts or all of this tract fail to disappear and later in life may enlarge and become fluid. There is a thin tract guiding this descent which usually disappears by birth. In the developing embryo, the thyroid gland descends from the back of the tongue to its final position low in the front of the neck. It is important that a full examination of the head and neck, including endoscopic examination of the interior of the nose, tongue, the upper swallowing apparatus and the voice box (or larynx) is performed to check the common sites from which tumours may originate. These cancers originate within the lymph nodes themselves or from blood or bone marrow cells.īecause of this vast differential diagnosis, it is important to be seen by an ENT consultant with experience in head and neck surgery. The commonest type of cancer in younger people are lymphomas or leukaemia. Lymph node metastases that appear low in the neck can originate from other areas in the body such as breast, lung or bowel. Skin cancers of the head and neck, such as squamous carcinoma or malignant melanoma may also metastasise to the neck lymph nodes. Common “primary” sites (sites of origin) for metastases in the head and neck include the mouth, tonsils, base of tongue, sinuses, voice box (larynx), thyroid and salivary glands. When this happens the lymph nodes that contain tumour cells are called metastases. Almost all cancerous growths in the head and neck spread via the neck lymph nodes. ![]() The most important condition to exclude however is cancer. Generalised rheumatological disorders with multiple symptoms in other parts of the body including the joints and blood vessels: sarcoidosis and autoimmune conditions like systemic lupus erythematosus.Other infections like toxoplasmosis or bartonella which in these cases can be transmitted from cats. Chronic (long standing) infections include: Tuberculosis, atypical mycobacteria (mainly in children), HIV and associated infections.Acute (short lived) infections include: viral or bacterial upper respiratory tract infections including tonsillitis and glandular fever.Lymph nodes that are greater than about 1 cm that persist for more than 2 weeks need further investigation, although reassuringly most of these will be harmless (reactive). The commonest sites in the neck are just below the angle of the jaw bone and further down at the nape of the neck. Did you know there are about 200 lymph nodes throughout the neck? They are your head and neck’s defence mechanism against infection, trauma and even cancer and frequently enlarge when your body is fighting these diseases. ![]()
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