There are many possible causes of neck lumps and they can be a source of worry and anxiety. Most are benign and not cancerous, though all neck lumps that do not settle after a couple of weeks should be checked by a doctor and it may be necessary to see a head and neck specialist. Many neck lumps are caused by infections and treatment will allow speedy resolution. Lumps which do not settle need further investigation including ultrasound and needle aspiration to diagnose.
There are a large number of lymph nodes (glands) in the neck, they are an important part of the body’s immune system. They normally range in size from a few millimetres to a centimetre but they can increase in size for a variety of reasons, and this is the most common reason for neck lumps. It could be because they have mounted a significant immune response, because they have become inflamed or infected, or it could be associated with cancer. Malignant causes of enlarged lymph nodes include lymphoma (a cancer of the lymph system) and cancerous cells which have spread from the nose, mouth, throat, larynx (voice box) or tongue. Investigation of swollen neck glands should therefore always include a clinical examination of these areas.
Thyroid and cysts
In children and young adults, lumps relating to development of the structures of the neck can develop into cysts which can cause neck lumps that will often require surgical removal. Abnormal swellings of the thyroid gland can cause lumps low in the neck which move on swallowing. These are very often benign but will require investigation.
Other causes for lumps in the neck include inflamed or infected salivary glands. The submandibular gland can particular become swollen in response to infection or blockage of the duct by stones. Lumps in the parotid gland are more often caused by tumours which are usually benign. Surgery is required and is technically challenging because of the presence of the facial nerve running through the gland. This sort of surgery should therefore be undertaken by surgeons with particular expertise in this type of problem. Although all neck lumps in children and adults should be investigated, the probability of throat cancer increases with age. This is particularly true of people who smoke or drink heavily. If you are worried about a neck lump you should seek professional medical advice from your GP or an otolaryngologist (ENT specialist).