11
Table 4. Common Ancillary Tests for Evaluation of an Adult
Neck Mass
a
Ancillary Test Suspected Disease
Complete Blood Count (CBC)
with differential
WBC elevation: Bacterial infection, lymphoma
WBC depression: immunosuppression
Anti-neutrophil antibody (ANA),
Anti-Ro/SSA, Anti-La/SSB
Autoimmune diseases such as Sjogren's syndrome
or Systemic Lupus Erythematosus (SLE)
Estimated Sedimentation Rate
(ESR)
Autoimmune diseases as mentioned above—non-
specific marker for systemic inflammation
yroid Stimulating Hormone
(TSH)
Elevated: toxic multinodular goiter
Decreased: Hashimoto's thyroiditis, Graves'
disease
Parathyroid Hormone (PTH) Parathyroid adenoma/hyperplasia or carinoma
HIV Enzyme-linked assay Human immunodeficiency virus (HIV) infection
Epstein-Barr virus antibody titers Epstein-Barr virus (EBV) infection
CMV IgM Titer Cytomegalovirus (CMV) infection
Mantoux tuberculin test (PPD) Mycobacterium tuberculosis infection
Bartonella Titer Bartonella infection (Cat Scratch Disease)
yroid Ultrasound yroid nodule, thyroid goiter
Parathyroid adenoma
CT, Chest with contrast Mycobacterium tuberculosis, non-tuberculosis
atypical mycobacterium, sarcoidosis, lung
malignancy
yroglobulin FNA-Needle Wash
Assay
yroid cancer
a
Tests from this list should be chosen selectively, based on clinical suspicion. Ancillary testing should
not delay work up of a possible malignancy.
