Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39126, USA.
Med Clin North Am. 2010 Sep;94(5):1017-29. doi: 10.1016/j.mcna.2010.05.007.
The objective of this article is to provide the internist with general considerations when confronted with an adult patient presenting with a neck mass. A thorough gathering of historical information and a complete physical examination are crucial in developing a differential diagnosis for these patients. Specifically, the location of the mass, its time of onset, and duration are important because of the high likelihood of neoplastic processes in patients older than 40 years. The young adult patient has an increased incidence of inflammatory, congenital, and traumatic processes as causes of their neck mass, but again, neoplasms are not out of the realm of possibility. Judicious use of imaging studies, namely computed tomography scanning with contrast, is a valuable adjunct to the physical examination. Other than infectious etiology, referral to an otolaryngologist is frequently warranted to obtain a definitive diagnosis for the development of an appropriate treatment plan, which is predominantly surgical.
本文的目的是为内科医生提供在面对出现颈部肿块的成年患者时的一般考虑。详细采集病史和进行全面体格检查对于为这些患者建立鉴别诊断至关重要。具体而言，肿块的位置、发病时间和持续时间很重要，因为 40 岁以上患者发生肿瘤的可能性很高。年轻成年患者的颈部肿块的病因更多为炎症、先天和创伤性疾病，但同样，肿瘤也并非不可能。明智地使用影像学检查，即增强 CT 扫描，是对体格检查的有价值的补充。除感染性病因外，通常需要转至耳鼻喉科医生以获得明确诊断，从而制定适当的治疗计划，主要是手术治疗。
