fine needle aspiration (FNA) can often provide a timely diagnosis with less morbidity to the patient and

decreased cost compared to open biopsy.

When evaluating a patient with a solitary neck mass, age of the patient is an
important factor in determining the differential diagnoses. Individuals younger
than 40 years are overwhelmingly diagnosed with benign processes such as
congenital and inflammatory lesions. In patients older than 40 years, the
differential diagnoses shift, as more than 60% of lesions are associated with
malignancy. 

malignancy include hoarseness, otalgia, unilateral hearing loss, hemoptysis,

weight loss, dysphagia, and odynophagia. A history of fever, night sweats,
and weight loss may suggest lymphoma. Physical exam findings of overlying
skin ulceration, firmness, or size greater than 1.5 cm are physical exam
findings more suggestive of malignancy.

Objectives:
 To identify the family structure of the index patient
 a scheme or graphic chart representation of both the genetic pedigree
of family and key psychosocial and interactional data (GENOGRAM)
 To understand normal family function (?)
 Elicits patient’s perception of current state of his/her family relationships
Serves as a rapid screening instrument for family dysfunction (APGAR)
 Brief, graphic method for disclosing, gathering & discussing family
dynamics as discussed by one or more family members. (FAMILY
CIRCLE)
 Assess the family as to its capacity to participate in provision of health
care or to cope with crisis. (SCREEM)
 Facilitates the communication of information about the family system &
its dynamics in order to address psychosocial issues (ECOMAP)