ear, nose, and throat disorders
Neck Lump
Evaluation of a Neck Lump
The following information can help people decide whether a doctor’s evaluation is needed and help them know what to expect during the evaluation. In people with a neck lump, certain symptoms and characteristics are cause for concern. They include A very hard lump Sores or growths in the mouth Difficulty swallowing and/or hoarseness A new lump or lumps in an older person In general, painless lumps are somewhat more worrisome than painful ones. People who have any type of neck lump for more than a few days should see a doctor, particularly people with warning signs. People with other symptoms (such as fever) should see a doctor as soon as possible. Doctors ask questions about the person's symptoms and medical history and do a physical examination. What doctors find during the history and physical examination helps decide what, if any, tests need to be done. During the medical history, doctors ask about the following: Symptoms of colds (such as a sore throat, sneezing, and a runny nose), and throat infections (such as pain when swallowing), and dental infections (such as toothache) Symptoms of cancer in the neck (such as difficulty speaking or swallowing) as well as risk factors for cancer, particularly smoking and drinking alcohol Risk factors for HIV and tuberculosis infection During the physical examination, doctors focus on the ears, nose, and throat (including the tonsils, base of the tongue, and thyroid and salivary glands). They look for signs of infection or abnormal growths, including looking down the throat with a mirror or a thin flexible viewing tube (laryngoscopy). They also feel the neck lump or lumps to determine whether the lump is soft, rubbery or hard and whether it is tender. If there is an obvious source of infection (such as a cold or a sore throat) or if the person is young and healthy and has a tender lump present for only a few days, no tests are needed immediately. Such people are watched closely to see whether the lump goes away without treatment. If it does not go away, tests are needed. Most other people should have a complete blood count (CBC) and a X-Rays . If younger people have no risk factors for cancer or findings that suggest cancer (such as mouth growths), imaging tests are often done, sometimes followed by biopsy. For older people, particularly those with warning signs or risk factors for cancer, doctors often do several tests to look for a source of cancer before they remove a piece of the lump (a needle biopsy) or the entire lump for testing (an excisional biopsy). Tests often include blood tests and To look for cancer originating in other parts of the body, doctors usually take x-rays of the upper digestive tract, a thyroid scan, and a CT scan of the chest. Direct examination of the larynx (laryngoscopy), lungs (bronchoscopy), and esophagus (esophagoscopy) with biopsies, done at the same time, may be needed. 