Feeling a lump in the neck can be concerning. While unsettling, neck lumps are common. The neck contains various structures like lymph nodes, glands, and muscles, which can develop noticeable swellings. Understanding their potential causes helps determine next steps.
Common Causes of Neck Lumps
Swollen lymph nodes are among the most frequent reasons people feel a lump in their neck. Lymph nodes are small, bean-shaped glands that filter lymph fluid and trap pathogens. When the body fights an infection, such as a common cold, strep throat, or mononucleosis, lymph nodes in the neck can enlarge and become tender as they work to combat the illness.
Thyroglossal duct cysts form from thyroid gland remnants, typically appearing in the middle of the neck. Branchial cleft cysts develop from improperly closed tissues, usually found on the side of the neck, often near the ear or collarbone. Both types are generally present from birth but may only become noticeable if they become infected or swell. Lipomas, another benign cause, are soft, movable fatty tumors that grow slowly just beneath the skin and are usually harmless.
The thyroid gland, located at the base of the neck, can develop benign thyroid nodules. These nodules are very common, though most are too small to feel. While a thyroid nodule can sometimes be a sign of cancer, the vast majority are benign and do not pose a serious health risk. They often feel like a firm, distinct lump that moves when swallowing.
Less Common but Significant Causes
While many neck lumps are benign, some can indicate more serious underlying conditions, though these are less common. Malignant lymph nodes can occur when cancer cells spread from a primary tumor elsewhere in the body to the lymph nodes, or originate in the lymphatic system (lymphoma). These nodes often feel firm, fixed, and may not be tender. The presence of multiple enlarged nodes, especially if accompanied by other systemic symptoms, warrants prompt evaluation.
Thyroid cancer is another potential cause of a neck lump, though it is considerably less common than benign thyroid nodules. This type of cancer often presents as a firm, painless lump or nodule in the thyroid gland. While it is a less frequent diagnosis, most forms of thyroid cancer are highly treatable, particularly when detected early. Salivary gland tumors can also manifest as lumps in the neck, typically located under the jaw or in front of the ear. These tumors can be either benign or malignant, and their growth pattern and associated symptoms help differentiate between the two.
Infections beyond common viruses can also lead to persistent or unusual neck lumps. For example, tuberculosis can cause enlarged lymph nodes in the neck that may be firm and painless. Additionally, certain vascular abnormalities, such as an aneurysm of a carotid artery, can present as a pulsatile mass in the neck. The characteristics of the lump, including its texture, mobility, and associated symptoms, are important in distinguishing these less common but significant causes from more benign conditions.
Important Signs and When to Seek Medical Care
Certain neck lump characteristics indicate when to seek medical attention. A lump that is growing rapidly, or one that appears suddenly without an obvious cause like a recent infection, should prompt a visit to a healthcare provider. Lumps that feel firm, fixed to surrounding tissues, or are not easily movable are also concerning signs.
Any neck lump accompanied by pain, tenderness, or changes in the skin overlying it, such as redness or warmth, warrants evaluation. Associated systemic symptoms are also important. These can include unexplained weight loss, night sweats, persistent fever, or unusual fatigue.
Difficulty swallowing (dysphagia) or breathing (dyspnea), as well as changes in voice such as new or worsening hoarseness, are also serious signs that require immediate medical assessment. Any neck lump that persists for more than a few weeks without improvement, even if initially thought to be benign, should also be examined by a doctor. Early evaluation is important for proper diagnosis and management.
The Diagnostic Process for Neck Lumps
When a healthcare professional evaluates a neck lump, the process starts with a comprehensive medical history and physical examination. The doctor will ask about the lump’s duration, any changes in its size or consistency, and associated symptoms like pain, fever, or difficulty swallowing. During the physical exam, the doctor will carefully feel the lump, assessing its size, shape, texture, mobility, and tenderness, as well as examining other areas of the head and neck.
Imaging tests are often the next step to gain a clearer picture of the lump. Ultrasound is often the first imaging choice because it is non-invasive, widely available, and can distinguish between solid and fluid-filled masses. It provides detailed information about the lump’s size, location, and internal characteristics. Depending on the ultrasound findings, a computed tomography (CT) scan or magnetic resonance imaging (MRI) may be used to provide more comprehensive views of the neck structures and their relationship to the lump. These scans can reveal the extent of the lump and whether it is involving surrounding tissues.
In some cases, blood tests may be ordered to check for signs of infection or to assess thyroid function, if a thyroid nodule is suspected. However, the definitive diagnostic tool for many neck lumps is a biopsy. This procedure involves taking a small tissue sample from the lump for microscopic examination by a pathologist. A fine needle aspiration (FNA) is a common type of biopsy where a thin needle is used to collect cells. In other instances, a surgical excisional biopsy, which removes the entire lump or a portion of it, may be necessary to obtain a conclusive diagnosis.
Citations:
Swollen glands – NHS. Lymphadenopathy – StatPearls – NCBI Bookshelf.
Thyroglossal Duct Cyst – StatPearls – NCBI Bookshelf.
Branchial Cleft Cyst – StatPearls – NCBI Bookshelf.
Lipoma – Mayo Clinic.
Thyroid Nodules – American Thyroid Association.
Lymphoma – Mayo Clinic.
Thyroid Cancer – National Cancer Institute.
Salivary Gland Tumors – American Cancer Society.
Cervical Lymphadenitis – StatPearls – NCBI Bookshelf.
Neck Lumps in Adults – American Academy of Otolaryngology—Head and Neck Surgery.
Unexplained Weight Loss – Mayo Clinic.
Physical Examination – Cleveland Clinic.
Neck Ultrasound – RadiologyInfo.org.
CT Scan and MRI – National Institute of Biomedical Imaging and Bioengineering.
Fine-Needle Aspiration Biopsy – National Cancer Institute.