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Branchial cyst
Thyroglossal duct cyst
Dermoid cyst
Cystic hygroma
Nonspecific lymphadenitis
Submandibular sialadenitis
Tuberculosis
Heerfordt syndrome
Sjögren syndrome
Hodgkin disease
Metastatic carcinoma in the lymph nodes

Branchial Cyst
Thyroglossal duct cysts very often appear in the midline of the neck, usually below
the hyoid bone and submentally. Clinically, the lesion presents as a painless,
fluctuant, movable swelling.
Definition Thyroglossal duct cyst is a rare developmental lesion that may form
along the thyroglossal tract.
Clinical features The cyst is usually located under the hyoid bone but can be
located anywhere fromthe suprasternal notch to the foramen cecumof the dorsal
tongue. Intraorally, it appears as a painless, fluctuant swelling usually 1–3 cm in
diameter, located in the midline of the dorsumof the tongue close to the foramen
cecum. Occasionally, a fistula may form following infection. The cyst is most often
diagnosed in patients under 20 years of age.
Dermoid Cyst
Dermoid cysts, when they develop below the geniohyoid muscle, protrude submentally
as a painless, doughy swelling . In such cases, the differential diagnosis should
include thyroglossal duct cyst, periapical and soft-tissue abscesses, and
sublingual sialadenitis.
Cystic Hygroma
Definition Cystic hygroma is a form of lymphangioma that consists of large cystic
spaces.
Etiology Developmental.
Nonspecific Lymphadenitis
Clinical features Lymph nodes in the neck area (submandibular, subdigastric, mid-
jugular, low jugular, cervical) may produce neck swellings. In acute infections,
the lymph nodes appear enlarged, tender, soft, and movable, while in chronic
conditions they are enlarged, but not tender, and are firm, and occasionally fixed.
Enlarged lymph nodes may be single or multiple.
Submandibular Sialadenitis
Treatment Antibiotics

Submandibular sialadenitis: swelling at the angle of the mandible and the neck.
Tuberculosis
Oral manifestations of tuberculosis are uncommon and present as a wide spectrumof
lesions, usually secondary to pulmonary infection. Regional lymphadenopathy usually
accompanies the oral lesions.
A particular formof cervical lymph-node tuberculosis is known as scrofula.
Clinically, it presents as a swelling of numerous cervical lymph nodes that
occasionally leads to the formation of numerous fistulas though the overlying skin.
The differential diagnosis should include lymphoma, submandibular sialadenitis, and
actinomycosis.

Heerfordt Syndrome
Treatment Steroids. Often the symptoms resolve spontaneously within two or three
years.

Sjögren Syndrome
Etiology Unknown.
Clinical features Two forms of the disease are recognized: primary and secondary,
when it is associated with collagen diseases. The cardinal clinical manifestations
include a recurrent enlargement of the parotid, submandibular and lacrimal glands,
lymphadenopathy, purpura, Raynaud phenomenon, myositis, and renal and pulmonary
manifestations. Keratoconjunctivitis sicca, xerostomia, cheilitis, dental caries,
and candidiasis are common manifestations. The disease most frequently affects
women between 40 and 60 years of age.
Hodgkin Disease
Etiology Unknown.
Clinical features Painless and persistent swelling, usually of the cervical and
supraclavicular lymph nodes or other lymph-node groups, is the common presenting
sign. In the early stages the lymph nodes are often movable, and later they become
fixed to the surrounding tissues. Anorexia, weight loss, fever, night sweats, and
pruritus may accompany lymphadenopathy. Oral ulceration may also occur.

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