A neck lump is any noticeable swelling or mass on the neck. These can vary in size and appear in various locations, such as under the chin, behind the ear, or on the side of the neck. While finding a neck lump can be concerning, it’s important to know that most are common and not serious, often being non-cancerous.
The Prevalence of Neck Lumps
Neck lumps are common across all age groups. While unsettling, the vast majority are benign. For instance, most neck lumps in children and younger adults are not cancerous, and even in adults, most thyroid nodules are non-cancerous.
Some lumps are temporary and resolve on their own, while others persist. A neck lump often indicates the body’s immune system is responding to an infection or inflammation.
Common Reasons for Neck Lumps
One frequent cause of a neck lump is swollen lymph nodes. These small, bean-shaped structures are part of the immune system. When the body fights an infection, such as a cold, strep throat, or flu, lymph nodes can become enlarged and tender as immune cells activate. This swelling is a natural response and typically resolves as the infection clears.
Cysts are another common type of neck mass, often fluid-filled sacs. These include sebaceous cysts, filled with an oily substance, or epidermoid cysts, containing keratin. Congenital cysts, like thyroglossal duct cysts or branchial cleft cysts, develop from tissues that didn’t fully form during embryonic development. Thyroglossal duct cysts are typically in the middle of the neck and move with swallowing, while branchial cleft cysts usually appear on the side.
Issues with the thyroid gland, located at the base of the neck, can also cause lumps. Thyroid nodules are growths within the gland, and most are benign, but can be noticeable. An enlarged thyroid gland, known as a goiter, can also appear as neck swelling. Salivary gland problems, such as inflammation or stones, can cause swelling under the jaw or in other neck areas.
Lipomas are benign fatty tumors that commonly form just beneath the skin. These lumps are generally soft, movable, and typically painless, though they can cause discomfort if they press on nerves. They are slow-growing and often go unnoticed until prominent.
When a Neck Lump Needs Medical Review
While many neck lumps are benign, certain characteristics warrant medical evaluation. Seek medical advice for any lump that persists over two to three weeks without an obvious cause, like a recent infection. A lump that continues to grow or changes rapidly in size also requires review.
Lumps that feel hard, fixed, or are not easily movable raise more concern than soft, movable ones. A painless lump can also be a red flag, as benign lumps are often tender or painful. Additional symptoms suggesting medical attention include unexplained weight loss, night sweats, or persistent fever.
Difficulty swallowing or breathing, voice changes, or a persistent sore throat also warrant a doctor’s visit. Lumps in individuals over 40, especially those with a history of smoking or significant alcohol use, carry a higher potential for concern and should be evaluated. Any new or changing neck lump is best assessed by a healthcare provider for accurate diagnosis.
The Diagnostic Process for Neck Lumps
When visiting a doctor for a neck lump, the diagnostic process begins with a thorough medical history and physical examination. The doctor will ask about the lump’s duration, associated symptoms, and personal history, such as smoking or alcohol use. During the exam, the doctor assesses the lump’s size, shape, consistency, tenderness, and mobility, also checking for other lumps in the neck.
Following initial assessment, various tests may be ordered. Imaging tests visualize the mass and surrounding structures. An ultrasound is often a first-line tool, providing detailed images of lymph nodes, salivary glands, and the thyroid, helping differentiate between solid and fluid-filled lesions. For a more detailed view, CT scans or MRI may assess the lump’s extent and its relationship to deeper tissues.
Blood tests also provide diagnostic clues. For instance, a complete blood count (CBC) can indicate infection if the white blood cell count is elevated. Blood tests may also check thyroid function if a thyroid issue is suspected.
If initial evaluation and imaging do not provide a definitive diagnosis, a biopsy may be necessary. A fine needle aspiration (FNA) biopsy is a common, minimally invasive procedure using a thin needle to extract a cell sample for analysis, often done in-office. If more tissue is needed, a core needle biopsy (larger needle) or an open biopsy (small incision) may be considered. Treatment depends entirely on the diagnosis from this comprehensive evaluation.