Head and Neck Radiology Differential Diagnosis

Cystic Lesions in the Neck
SUBLINGUAL

Thyroglossal Duct Cyst (Midline)
Cervical Dermoid Cyst (Midline)
Ranula (In Sublingual Space from Obstruciton of Salivary Gland Duct) Plunging Ranula (Ruptured Ranula Extends into Submandibular Space)
Abscess
Necrotic Node or Tumor

Cystic Lesions in the Neck
SUBMANDIBULAR

Branchial Cleft Cyst (Below the Angle of the Mandible, Anteromedial to
the Sternocleidomastoid, Lateral to Carotid Sheath)
Thyroglossal Duct Cyst (Midline)
Abscess
Necrotic Node or Tumor
Cystic Hygroma (type of Lymphangioma, Lateral)
Laryngocele

Destructive Masses of Paranasal Sinuses

SCC
Lymphoma (Present Around Bone without Destroying It)
Salivary Tumors (Adenoid Cystic and Mucoepidermoid Carcinoma)
Mets
Granulomatous Dz
Infections (Mucor and Aspirgillis)
Inverting Papilloma
Anterochoanal Polyp
IN CHILD
Rhabdomyosarcoma
Esthesioneuroblastoma (in superior nasal cavity)
Lymphoma
IN ADOLESCENT
Juvenile Nasal Angiofibroma (In Pterygopalatine Fossa)

Parotid Space Mass

TUMORS
Pleomorphic Adenoma (F>M, 70% of All Benign Parotid Tumors)
Warthins Tumor (M>F and Bilateral, 2nd Most Common Benign Tumor)
Squamous Cell Carcinoma
Mucoepidermoid
Adenoid Cystic
Lymphoma (Usually Secondary)
Metastatic Lymphadenopathy
INFECTIOUS/ INFLAMMATORY
Acute Sialadenitis (Obstruction of Duct with Stone)
Abscess
Sjogren’s Parotiditis (Triad Includes Dry Eyes and h Lacrimal Glands.
Bilateral. Lymphoepithelial Infiltrates on Pathology.
Associated with an Autoimmune Disorder)
Lymphoepithelial Cysts in HIV (Bilateral)
Sarcoid
Mumps

Pharyngeal Mucosal Space Mass

SCC
Thornwald’s Cyst
Tonsilar Abscess
Lymphoma
Rhabdomyosarcoma

Parapharyngeal Space

Salivary Gland Tumors
Nasopharyngeal Carcinoma
Neurogenic Tumor
Glomus Vagale
Lympadenopathy
Abscess/Cellulitis

Jugular Foramen/ Carotid Space Mass

Paraganglioma (Glomus Jugularis, Carotid Body Tumor)
Neurofibroma
Schwannoma
Chondrosarcoma
Mets
Meningioma

Petrous Apex Mass

Epidermoid
Cholesterol Granuloma
Chondrosarcoma
Mucocele
5th Nerve Schwannoma
Mets
Carotid Artery Aneurysm

Clivus Mass

Chordoma
Mets
Plasmacytoma
Chondrosarcoma

Leukokoria (Child)

Retinoblastoma (mean 18 months)
Persistent Primary Vitreous (no ca++)
Coat’s Disease (6-8 years)
Toxocara
Retinopathy of Prematurity

Orbital Mass (Child)

Rhabdomyosarcoma
Lymphangioma/Hemangioma
EG
Mets (Neuroblastoma, Leukemia, Ewing’s Sarcoma)

Conal Lesions

Graves (Tendons Spared)
Lymphoma
Pseudotumor (Tendons Involved)
Myositis
Acromegaly

Optic Nerve Lesions

Optic Nerve Glioma
Optic Nerve Sheath Meningioma
Optic Neuritis (MS)
Meningeal Carcinomatosis
Sarcoid

Intraconal Lesions

Optic Nerve Lesions
Hemangioma/ Lymphangioma
Lymphoma
Mets (Breast>Lung)
Pseudotumor
Infection
Enlarged Superior Ophthalmic Vein from CC Fistula
Orbital Varix

Extraconal Lesions

Lymphangioma
Mets (Breast>Lung)
Dermoid
Paranasal Sinus Dz

Enlarged Lacrimal Gland

Lymphoma
Sarcoid
Pseudotumor
Epithelial Tumors (Pleomorphic Adenoma, Adenoid Cystic)
Mets
Infection

Globe Mass

Uveal Melanoma
Uveal Mets (Breast>Lung)

Soft Tissue Mass in Middle Ear

Cholesteatoma
Cholesterol Granuloma
Glomus Tympanicum Tumor
Aberrant Internal Carotid Artery
High or Dehiscent Jugular Bulb

Odontogenic Neoplasm

Ameloblastoma
Odontogenic Cyst
AVM
Hemangioma
Simple Bone Cyst
ABC
Fibrous Dysplasia
Osteogenic Sarcoma

BENIGN CONGENITAL
Tornwaldt’s Cyst
Thyroglossal Duct Cyst
Branchial Cleft cyst
Cystic Hygroma
BENIGN INFLAMMATORY
Ranula
Retropharyngeal Abscess
BENIGN TUMORS
Lipoma
Juvenile Nasal Angiofibroma
Neurofibroma
MALIGNANT TUMORS
Lymphoma
Rhabdomyosarcoma
Clival Chordoma