Causes Of Lumps In The Neck

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Neck lumps have many causes but, thankfully, the majority are benign. However, a number of benign lumps will still need to be assessed, partly to rule out the possibility of anything more sinister being behind them but also in case surveillance or surgery is required.

To simplify the different possible diagnosis I tend to divide neck lumps into the following common categories:

1. A neck lump arising from a lymph node in the neck

Lymph nodes are part of the immune system. The most common reason for a lump in the neck arising from a lymph node is an upper respiratory tract infection (including pharyngitis and tonsillitis) but they can also occur as a result of inflammation from scalp dermatitis or psoriasis. Malignant lymph node lumps do also occur and must be thought of if a lump is getting progressively bigger or is associated with other upper respiratory or digestive tract symptoms such as ear pain, hoarseness and difficulty or pain on swallowing.

2. A neck lump that although not always obvious has been there from birth.

The two most common congenital lumps include a thyroglossal duct cyst and a branchial cyst.

3. A lump that classically arises from one of the three major pairs of salivary glands found in and around the mouth and which are responsible for producing saliva

We have three pairs of major salivary glands (parotid, submandibular and sublingual) and many minor salivary glands. Lumps in the neck caused by salivary glands will usually be parotid and submandibular salivary gland swellings. Both of these may be affected by inflammatory conditions.

4. A lump arising from the thyroid gland, which is found at the base of the neck

A swelling of the thyroid gland is often referred to as goitre. The majority of swellings and lumps in the thyroid gland are completely benign. Thyroid cancer itself is extremely rare. A lump in the thyroid does however require investigation so that a diagnosis of a benign swelling can be made. Ultrasound and fine needle aspiration are used after a full clinical history and examination have been undertaken. Often a repeat fine needle aspiration will be undertaken a few months after the first to completely confirm that the thyroid lump is benign.

Surgical removal of the thyroid gland may be undertaken for the following reasons:

i. Malignant disease of the thyroid
ii. Suspicion of malignant disease of the thyroid
iii. Compression of the airway (oesophagus) by the thyroid gland
iv. Uncontrolled medical problems of the thyroid
v. Cosmetic reasons

About the Author:
Francis Vaz is a Consultant ENT and Head and Neck Surgeon at University College London Hospital. He also practices privately within the Harley Street Clinic.

totalhealth provides authoritative medical information in plain English, including more articles on neck lumps



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