A lump, swelling, or mass on the neck can be concerning. While discovering a new bump can feel alarming, it’s important to recognize that many neck lumps are not serious. The neck contains various structures like muscles, glands, and lymph nodes, all of which can develop swellings. Understanding their common characteristics helps distinguish between benign and those warranting medical evaluation.
Common Benign Causes
The most frequent reason for a neck lump is an enlarged lymph node. Lymph nodes are small, bean-shaped immune system structures that filter fluid and trap pathogens. They swell in response to common infections like the common cold, strep throat, or mononucleosis, becoming tender. These swollen nodes subside as the infection clears.
Cysts are another common neck lump. These are sacs filled with fluid, air, or debris. Epidermoid cysts arise from skin cells and can appear on the neck. Sebaceous cysts originate from oil glands in the skin. These cysts are soft and movable, though they can become inflamed or infected, leading to pain and redness.
Lipomas are benign growths of fatty tissue beneath the skin. These lumps are soft, movable, and painless, feeling rubbery or doughy. They are slow-growing and vary in size. A lipoma might cause discomfort if it presses on nerves or grows very large.
Skin tags or moles are common skin growths on the neck. These are small, soft growths projecting from the skin, or pigmented spots. Muscle knots, or myofascial trigger points, can also present as hard, localized areas in neck muscles. These knots occur due to muscle tension, overuse, or injury, causing pain that may radiate to the shoulders or head.
Less Common or Concerning Causes
Certain other causes of neck lumps warrant closer attention. The thyroid gland, located in the front of the neck, can develop nodules. While most thyroid nodules are benign, some can be cancerous. Larger nodules might cause difficulty swallowing, breathing issues, or voice changes.
Salivary glands, found under the jaw and near the ears, can be a source of neck lumps. Conditions like salivary gland stones (sialolithiasis) can block saliva flow, leading to swelling and pain. Untreated blockages can lead to infections or abscesses.
Infections can cause persistent or more severe lymph node swelling. Tuberculosis can affect neck lymph nodes, presenting as scrofula, a painless, gradually enlarging mass. Cat-scratch disease, caused by bacteria from cat scratches or bites, can result in tender, swollen lymph nodes, accompanied by fever or fatigue.
Other benign tumors, distinct from lipomas or cysts, can form in the neck. These include non-cancerous growths of nerve tissue or blood vessels. A neck lump can also signal a more serious condition, such as malignant growths. These include lymphomas or head and neck cancers that originate in areas like the mouth, throat, or thyroid and spread to neck lymph nodes.
When to Seek Medical Attention
Certain characteristics and accompanying symptoms indicate the need for medical evaluation. A lump that appears suddenly or grows rapidly should be assessed. Any lump that is painful, tender, warm, or red could suggest an an infection or inflammation.
A lump that feels hard, fixed, or immovable is a concerning sign. Systemic symptoms accompanying a neck lump also warrant medical consultation. These include unexplained fever, unintentional weight loss, drenching night sweats, or persistent fatigue.
Difficulty swallowing or breathing, voice changes, or persistent sore throat require urgent medical review. If a neck lump persists for more than a few weeks without a clear cause, or if it appears in an infant or young child, it should be evaluated.
Diagnostic Process and Management
When seeking medical attention for a neck lump, the initial evaluation involves a thorough physical examination and detailed medical history. The doctor assesses the lump’s size, consistency, tenderness, and mobility, and inquires about associated symptoms, recent illnesses, or exposures. This assessment guides the diagnostic process.
Imaging tests visualize the lump and surrounding structures. An ultrasound is often the first imaging, as it differentiates between solid and fluid-filled masses. For a comprehensive view, a computed tomography (CT) scan or magnetic resonance imaging (MRI) can assess the lump’s depth, its relationship to nearby vessels and nerves, and check for other abnormalities.
A biopsy, which involves removing a tissue sample for laboratory analysis, is necessary to determine the lump’s nature. A fine needle aspiration (FNA) biopsy extracts cells from the lump. If more tissue is needed, a core biopsy or an excisional biopsy (surgical removal of the entire lump) can be performed.
Management varies depending on the underlying cause. For benign conditions like swollen lymph nodes due to infection, observation or antibiotics are sufficient. Cysts or lipomas that are symptomatic or cosmetically bothersome can be surgically removed. More complex causes, such as certain thyroid nodules or malignant growths, require specific medical or surgical interventions tailored to the diagnosis.