8
Diagnosis
Imaging
Î Clinicians should order a neck CT (or MRI) with contrast for patients
with a neck mass deemed at increased risk for malignancy. (S-B)
Fine Needle Aspiration
Î Clinicians should perform FNA instead of open biopsy, or refer the
patient to someone who can perform FNA, for patients with a neck
mass deemed at increased risk for malignancy when the diagnosis of
the neck mass remains uncertain. (S-A)
Cystic Masses
Î For patients with a neck mass deemed at increased risk for
malignancy, clinicians should continue evaluation of patients with a
cystic neck mass, as determined by FNA or imaging studies, until a
diagnosis is obtained and should not assume the mass is benign. (R-B)
Ancillary Tests
Î Clinicians should obtain additional ancillary tests based on the
patient's history and physical examination when a patient with a
neck mass is at increased risk for malignancy and/or does not have a
diagnosis after FNA and imaging. (R-C)
Examination Under Anesthesia of the Upper Aerodigestive Tract
Before Open Biopsy
Î Clinicians should recommend examination of the upper aerodigestive
tract (under anesthesia and before open biopsy) for patients with a
neck mass who are at increased risk for malignancy and without a
diagnosis or primary site identified by FNA, imaging, and/or ancillary
tests. (R-B)
Diagnosis
