A lump on the neck is in most cases a benign change, but due to a possible malignant diagnosis, it should not be ignored, especially in adults
Perhaps there is no single clinical finding in medicine with such a wide differential diagnosis as a lump on the neck. The range of seriousness of these diagnoses is incredible, from a harmless subcutaneous change to a nodule that is an indicator of a malignant disease in its final stage.
Lumps on the neck in children and adults should also be viewed in a different context. In children, this is often a normal constitutional feature, since children have a lymphatic constitution, and these lymph nodes are a reflection of their positive immune response and the development of the immune system.
Therefore, in fact, almost every child of kindergarten age has palpable lymph nodes on the neck that appear or occasionally increase existing ones. In adults, the appearance of a lump on the neck is something that requires a more serious diagnostic approach because it can often be a serious disease. However, it should be emphasized that lumps on the neck are much more often benign changes.
Enlargement of lymph nodes
Lymph nodes are lumps on the neck that are quite normal in children. In addition to being present as part of the “normal” structure of the child, they can appear as a reflection of immune activity due to some inflammatory disease in the head and neck area.
Very often we are talking about acute infections of the upper respiratory tract, which can occur six to eight times a year in healthy children. Most of these inflammatory diseases are throat, sinus, ear infections or inflammatory processes in the oral cavity associated with caries.
Inflammation of the salivary glands or a stone that disrupts the flow of saliva from the salivary glands (most often the submandibular glands) can manifest as a lump on the neck. Lymph nodes can also be enlarged due to infection, as is the case in the very common case of infectious mononucleosis, so we also find enlarged lymph nodes there.
Changes in the skin of the neck
In addition to the mentioned lymph nodes, lumps on the neck can be some diseased change on the skin of the neck, such as atheroma, or enlarged sebaceous glands.
Changes in the thyroid gland
Often, changes in the thyroid gland can appear as a lump on the neck. And it can be an ordinary benign change in the thyroid tissue that occurs with aging, but also a serious malignant disease.
Changes in neck muscles
Changes can occur in the neck muscles that manifest as lumps. In the elderly, it is a question of degenerative changes such as calcifications, and in younger people, especially athletes, they can be the result of muscle rupture or bleeding in the muscle due to excessive exercise.
Congenital anomalies
Congenital anomalies are also possible in children and younger people, which do not always have to manifest at birth. These are gill arch cysts or lateral neck cysts, so-called. medial cyst of the neck related to the development of the thyroid and malformations of blood and lymphatic vessels, which we call hemangiomas and lymphangiomas.
In adults, benign nodules are subcutaneous changes such as lipomas – accumulations of fatty tissue and fibromas that are made of connective tissue.
Malignant diseases
What we have to be very careful about is the possible association of some lumps with malignant diseases. It is much more common in adults than in children. Or it is about diseases of the lymphatic system such as lymphomas, diseases of the blood system such as leukemia or some malignant diseases in which the lump on the neck is a metastasis of some malignant disease mainly in the head and neck area.
When to contact the doctor?
Any lump on the neck that is inflamed in the sense that it is red and painful and does not subside within 48 hours requires a visit to a primary care physician. A lump on the neck that is not inflamed but persists for more than six weeks also requires a visit to a primary care physician who will determine whether further treatment is needed.
The treatment consists of a clinical examination by an otolaryngologist and a head and neck surgeon and some additional radiological treatments such as neck ultrasound and magnetic resonance or CT. The highest level of processing is the puncture of the node with the aim of establishing a cytological diagnosis or the removal of the node for the purpose of establishing a pathohistological diagnosis.
Find more professional advice at the polyclinic for the diagnosis and treatment of ear, nose and throat diseases and for minimally invasive aesthetic surgery of the head and neck in Alba Rubra.
This text was created in collaboration with portal “ADIVA – your portal for health”
