Journal article
Evaluation of Neck Masses in Adults
American family physician, Vol.113(2), pp.156-165
02/01/2026
Abstract
Neck masses are often seen in clinical practice, and the family physician should be able to determine the etiology of a mass using organized, efficient diagnostic methods. The first goal is to determine if the mass is malignant or benign; malignancies are more common in adult smokers older than 40 years. Etiologies can be grouped according to whether the onset/duration is acute (e.g., infectious), subacute (e.g., squamous cell carcinoma), or chronic (e.g., thyroid), and further narrowed by patient demographics. If the history and physical examination do not find an obvious cause, imaging and surgical tools are helpful. Contrast-enhanced computed tomography is the initial diagnostic test of choice in adults. Computed tomography angiography is recommended over magnetic resonance angiography for the evaluation of pulsatile neck masses. If imaging rules out involvement of underlying vital structures, a fine-needle aspiration biopsy can be performed, providing diagnostic information via cytology, Gram stain, and bacterial and acid-fast bacilli cultures. The sensitivity and specificity of fine-needle aspiration biopsy in detecting a malignancy range from 77% to 97% and 93% to 100%, respectively.
Details
- Title: Subtitle
- Evaluation of Neck Masses in Adults
- Creators
- Jason Wilbur - Department of Family and Community Medicine, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, United StatesValery L. Tran - University of Iowa, Family and Community MedicineMarc F. Doobay - University of Iowa
- Resource Type
- Journal article
- Publication Details
- American family physician, Vol.113(2), pp.156-165
- ISSN
- 0002-838X
- eISSN
- 1532-0650
- Language
- English
- Date published
- 02/01/2026
- Academic Unit
- Physician Assistant Studies; Family and Community Medicine; Injury Prevention Research Center
- Record Identifier
- 9985139308002771
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