What is it about ?
A ‘lump’ in the neck can be benign (swelling of the lymph nodes due to infection, cyst …), or malignant (for example, cancer of the lymph nodes (lymphoma)). To tell the difference, always take into account possible symptoms of infection, age and where the lump is located.
During an acute infection, the lymph nodes may be swollen on both sides of the neck. This swelling goes away spontaneously after some time. This patient guide only addresses the balls that are still present after 2 to 4 weeks or that have no obvious connection with an infection.
How to recognize it?
You may find a lump in your neck accidentally or because you have symptoms such as fever, pain, difficulty swallowing, or hoarseness.
At the children and adolescents, it can be:
- Swollen glands. They are often the consequence of an infection such as angina, mononucleosis or toxoplasmosis. There are usually other symptoms: fever, fatigue, lack of appetite, difficulty swallowing … Swollen lymph nodes on both sides, at the corners of the lower jaw, are common and rarely require further examination;
- Cysts filled with a liquid or semi-liquid substance, at the front of the neck, in the muscles. They are tense, but they give way when pressed;
- Malformations of the lymphatic system. They are rare and rather give the impression of a pasty mass;
- Tumors. They are rare at this age, but when they do, it is more often a malignant tumor than a benign tumor. A tumor is usually irregular in shape and is hard because it is made of strong tissue.
At the young adult (up to the age of 40), it can be:
- Swollen glands as a result of infection;
- Cysts in the neck;
- Tumors. They are more common in young adults. Most salivary gland and thyroid tumors are benign. But sometimes it is a malignant tumor, for example cancer of the thyroid or salivary gland, or metastasis from cancer of the head or neck. The salivary glands can usually be felt under and behind the lower jaw, while thyroid tumors are located further in the front of the neck.
At the house of adults (after 40 years), it may be cancer. Tumors located outside the thyroid region and the salivary gland region are usually malignant tumors; these are often metastases from tumors located elsewhere.
How is the diagnosis made?
The doctor will ask you detailed questions about your symptoms. Important elements are difficulty or pain when swallowing, hoarseness, local pain, previous cancer, contact with animals (to rule out certain infections) and general symptoms such as fever, fatigue, weight loss , loss of appetite and night sweats.
Next, the doctor will examine your neck, face, and possibly the nose, throat, and ear area. If necessary, he will also check the other lymph nodes (under the armpits, in the groin, above the collarbone, etc.).
In the presence of masses and swollen glands associated with a throat infection, one usually waits a month before scheduling additional examinations. Masses with a diameter less than 2 cm in children and adolescents are followed until they have disappeared or decreased in size.
If there is an obvious abnormality or uncertainty as to the nature of the tumor, the doctor will ask you to undergo medical imaging (ultrasound). On this occasion, a fine needle biopsy is often also carried out. A piece of tissue is removed from the tumor for examination. Unfortunately, quite often, even in the presence of a malignant tumor, the results are normal. This is why one can also immediately choose to have the tumor removed. Further examinations take place only if necessary and usually after examination by a specialist.
What can you do ?
If you notice a lump that does not go away or that worries you, you should contact your doctor.
What can the doctor do?
As soon as the cause of the lump is known, the doctor will discuss possible treatment with you. Treatment obviously depends on the cause. If the lump does not go away after treatment, you will be referred to a specialist for further examination. Usually, the doctor opts for surgical removal and a lump analysis.
Want to know more?
- Neck anatomy (image) – Larousse
- Lymphatic system and lymph nodes (image) – Larousse
- Thyroid (image) – Larousse
- Salivary glands: infections, stones (image) – mongeneraliste.be – SSMG – Scientific Society of General Medicine
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