Histopathological Spectrum of Benign and Malignant Non-thyroid Neck Masses in Adults

Abstract

Background: Neck masses in adults not related to the thyroid can have various benign and malignant origins, frequently posing diagnostic difficulties. Although FNAC is valuable for preliminary assessment, histopathology is considered the gold standard for conclusive diagnosis, aided by imaging and additional tests. The lack of sufficient local data in Bangladesh requires additional research to more accurately characterize their histopathological spectrum and enhance clinical management. Methods: This cross-sectional research involved 100 patients with neck masses not related to the thyroid at Dhaka Medical College Hospital over a six-month period (2019–2020). Clinical data were gathered and validated through histopathology, categorizing lesions as benign/inflammatory or malignant. Age, sex, and lesion origin associations were evaluated using Chi-square and Fisher’s exact tests (p < 0.05), with ethical approval and informed consent secured. Results: A total of 100 patients (average age 42.67 ± 8.42 years) were examined, with males representing 53%. Benign and inflammatory lesions were more common (73%, n=73) than malignant lesions (27%, n=27), resulting in a benign-to-malignant ratio of approximately 2.7:1. Reactive lymphadenopathy (36.9%) and tuberculous lymphadenitis (32.8%) accounted for the most frequent benign lesions, whereas metastatic carcinoma (33.3%) and non-Hodgkin lymphoma (25.9%) were the predominant malignancies. Malignancy showed a significant correlation with age (p=0.002), gender (p=0.031), and the source of lymph nodes (p=0.018). Conclusion: The majority of neck masses not related to the thyroid were benign or inflammatory, primarily consisting of reactive lymphadenopathy and tuberculous lymphadenitis. Malignancy was linked to advanced age, male gender, and lymph node origin, emphasizing the significance of histopathological diagnosis.

Journal of Paediatric Surgeons of Bangladesh (2026) Vol. 17 (2): 42-45