Differential Diagnosis for Cystic/Necrotic Lesions near Left Submandibular Gland in HIV Patients
- Single most likely diagnosis
- Tuberculous lymphadenitis: This condition is a common cause of cystic or necrotic lesions in the neck, particularly in HIV patients who are more susceptible to tuberculosis due to their compromised immune status.
- Other Likely diagnoses
- Reactive lymphadenitis: HIV patients can develop reactive lymphadenitis due to various infections or inflammatory conditions, which may present as cystic or necrotic lesions on imaging.
- Kaposi's sarcoma: This is a type of cancer that can occur in HIV patients, often presenting as lymphadenopathy or soft tissue masses, which may appear cystic or necrotic on CT scans.
- Lymphoma: Both Hodgkin and non-Hodgkin lymphoma can occur in HIV patients and may present with cystic or necrotic lymph nodes in the neck.
- Do Not Miss diagnoses
- Abscess: Although less likely, an abscess in the submandibular region can be life-threatening if not promptly treated, especially in immunocompromised patients.
- Squamous cell carcinoma: This type of cancer can present as a cystic or necrotic mass in the neck and is more common in HIV patients due to their increased risk of malignancies.
- Rare diagnoses
- Branchial cleft cyst: Although typically congenital, branchial cleft cysts can become infected and appear as cystic or necrotic lesions in the neck, including near the submandibular gland.
- Kimura disease: A rare, chronic inflammatory disorder that can cause lymphadenopathy and eosinophilia, potentially presenting with cystic or necrotic lesions on imaging, though it is more common in Asian populations.
- Castleman disease: A rare lymphoproliferative disorder that can present with lymphadenopathy, which may appear cystic or necrotic on CT scans, and is more common in HIV patients.