Neck Lumps
What causes a neck lump, when to seek specialist assessment, and what investigation involves.
What Causes a Neck Lump?
Neck lumps are extremely common. The vast majority are benign — most are reactive lymph nodes responding to infection, or benign cysts. However, a neck lump lasting more than 2–3 weeks without an obvious cause requires specialist evaluation to exclude cancer.
Common benign causes include reactive lymphadenopathy (infection), sebaceous cyst, thyroid nodule or goitre, salivary gland swelling (parotid or submandibular), branchial cyst, lymphangioma, and lipoma.
Causes requiring urgent investigation include lymph node metastasis from head and neck cancer (oral, throat, thyroid, salivary), lymphoma, and primary soft tissue tumours.
When to Seek Urgent Assessment
The lump has been present for more than 2–3 weeks · It is growing · It is painless · You smoke or use tobacco · You have any other head and neck symptoms · You are over 40
The common mistake is waiting too long. A neck lump caused by cancer is often painless — the absence of pain is not reassurance. Any unexplained neck lump lasting more than 3 weeks in an adult should be assessed by a head and neck specialist.
What Happens at Assessment
A specialist examination includes palpation of the neck and examination of the entire oral cavity, throat, and larynx. An ultrasound of the neck is usually arranged first. If a suspicious node is found, fine needle aspiration (FNAC) provides a tissue diagnosis. Depending on results, CT or PET-CT imaging may follow to identify the primary tumour.
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Dr. Narayana Subramaniam
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