Why most lumps appear
A lump or swelling in the neck is common, and most are harmless. The usual cause is a swollen lymph gland: the glands at the sides of the neck swell while the body fights an infection such as a cold, tonsillitis or an ear or throat infection, and they usually settle by themselves within one to two weeks. A lump at the front of the neck can come from the thyroid gland. Less often, a lump that does not go away is a sign of something that needs treatment, which is why a lump that stays is examined.
When a lump should be examined
A lump in the neck should be seen by a doctor if it:
- is still there after two weeks;
- is getting bigger;
- feels hard or does not move when you press it;
- appears with no other sign of an illness or infection;
- sits just above or below the collarbone;
- comes with night sweats or a high temperature that does not settle.
A lump together with a hoarse voice that lasts more than three weeks, a sore in the mouth that does not heal, or difficulty swallowing should also be examined. These signs are common and usually have another cause; they are a reason to be examined, not a diagnosis.
What the examination involves
The doctor asks how long the lump has been there and examines the neck, the mouth and the throat. An ear, nose and throat doctor can look at the throat and the voice box with a thin endoscope passed through the nose. If the cause is not clear, an ultrasound scan of the neck is usually the first test, and a sample of cells may be taken from the lump with a fine needle and examined under a microscope. Further scans are arranged only when they are needed.
After the result
Most lumps need no operation: an infection is treated, or the lump is watched until the swelling goes down. When a lump has to be removed, or proves to be a tumour, the treatment depends on what it is and where it sits.
This article gives general information; it does not replace an examination, a diagnosis or treatment.