What’s Causing This Lump on My Neck?


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Understanding lumps on the neck

A lump on the neck is also called a neck mass. Neck lumps or masses can be large and visible, or they can be very small. Most neck lumps aren’t harmful. Most are also benign, or noncancerous. But a neck lump can also be a sign of a serious condition, such as an infection or a cancerous growth.

If you have a neck lump, your healthcare provider should evaluate it promptly. See your healthcare provider right away if you have an unexplained neck mass.

Conditions that cause neck lumps, with pictures

Many conditions can cause neck lumps. Here is a list of 19 possible causes.

Warning graphic images ahead.

Infectious mononucleosis

Infectious mononucleosis
Image by: James Heilman, MD (Own work) [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons
  • Infectious mononucleosis is usually caused by the Epstein-Barr virus (EBV)
  • It mainly occurs in high school and college students
  • Symptoms include fever, swollen lymph glands, sore throat, headache, fatigue, night sweats, and body aches
  • Symptoms may last for up to 2 months

Read full article on infectious mononucleosis.


Thyroid nodules

Thyroid nodules
Image by: Nevit Dilmen [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], from Wikimedia Commons
  • These are solid or fluid-filled lumps that develop in the thyroid gland
  • They’re classified as cold, warm, or hot, depending on whether they produce thyroid hormones or not
  • Thyroid nodules are usually harmless, but may be a sign of disease like cancer or autoimmune dysfunction
  • Swollen or lumpy thyroid gland, cough, hoarse voice, pain in the throat or neck, difficulty swallowing or breathing are possible symptoms
  • Symptoms can indicate an overactive thyroid (hyperthyroid) or underactive thyroid (hypothyroid)

Read full article on thyroid nodules.


Branchial cleft cyst

Branchial cleft cyst
Image by: BigBill58 (Own work) [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons
  • Branchial cleft cyst is a type of birth defect in which a lump develops on one or both sides of a child’s neck or below the collarbone.
  • It occurs during embryonic development when tissues in the neck and collarbone, or branchial cleft, don’t develop normally.
  • In most cases, a branchial cleft cyst isn’t dangerous, but it may cause skin irritation or infection and, in rare cases, cancer.
  • Signs include a dimple, lump, or skin tag on your child’s neck, upper shoulder, or slightly below their collarbone.
  • Other signs include fluid draining from your child’s neck, and swelling or tenderness that usually occurs with an upper respiratory infection.

Read full article on branchial cleft cysts.


Goiter

Goiter
Image by: Dr. J.S.Bhandari, India (Own work) [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons
  • A goiter is an abnormal growth of the thyroid gland
  • It may be benign or associated with increases or decreases in thyroid hormone
  • Goiters may be nodular or diffuse
  • Enlargement may cause difficulty swallowing or breathing, coughing, hoarseness, or dizziness when you raise your arm above your head

Read full article on goiters.


Tonsillitis

Tonsillitis
Image by: Michaelbladon at English Wikipedia (Transferred from en.wikipedia to Commons.) [Public domain], via Wikimedia Commons
  • This is a viral or bacterial infection of the tonsil lymph nodes
  • Symptoms include sore throat, difficulty swallowing, fever, chills, headache, bad breath
  • Swollen, tender tonsils and white or yellow spots on tonsils may also occur

Read full article on tonsillitis.


Hodgkin’s disease

Hodgkin's disease
Image by: JHeuser/Wikimedia
  • The most common symptom is painless swelling of the lymph nodes
  • Hodgkins disease may cause night sweats, itchy skin, or unexplained fever
  • Fatigue, unintended weight loss, or persistent cough are other symptoms

Read full article on hodgkin’s disease.


Non-Hodgkin’s lymphoma

Non-Hodgkin's lymphoma
Image by: Jensflorian [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], from Wikimedia Commons
  • Non-Hodgkin’s lymphoma is a diverse group of white blood cell cancers
  • Classic B symptoms include fever, night sweats, and unintentional weight loss
  • Other possible symptoms include painless, swollen lymph nodes, enlarged liver, enlarged spleen, skin rash, itching, fatigue, and abdominal swelling

Read full article on non-Hodgkin’s lymphoma.


Thyroid cancer

Thyroid cancer
  • This cancer occurs when normal cells in the thyroid become abnormal and start to grow out of control
  • It’s the most common form of endocrine cancer with multiple subtypes
  • Symptoms include lump in the throat, cough, hoarse voice, pain in the throat or neck, difficulty swallowing, swollen lymph nodes in neck, swollen or lumpy thyroid gland

Read full article on thyroid cancer.


Swollen lymph nodes

Swollen lymph nodes
Image by: James Heilman, MD (Own work) [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons
  • Lymph nodes become swollen in response to illness, infection, medications, and stress, or, more rarely, cancer and autoimmune disease
  • Swollen nodes may be tender or painless, and located in one or more places throughout the body
  • Small, firm, bean-shaped lumps appear in the armpits, under the jaw, on the sides of the neck, in the groin, or above the collarbone
  • Lymph nodes are considered swollen when they are larger than 1 to 2 cm in size

Read full article on swollen lymph nodes.


Lipoma

Lipoma
  • Soft to the touch and moves easily if prodded with your finger
  • Small, just under the skin, and pale or colorless
  • Commonly located in the neck, back, or shoulders
  • Only painful if it grows into nerves

Read full article on lipoma.


Mumps

Mumps
Image by: Afrodriguezg (Own work) [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
  • Mumps is an extremely contagious disease caused by the mumps virus It spreads by saliva, nasal secretions, and close personal contact with infected people
  • Fever, fatigue, body aches, headache and loss of appetite are common
  • Inflammation of the salivary (parotid) glands causes swelling, pressure, and pain in the cheeks
  • Complications of infection include inflammation of the testicles (orchitis), inflammation of the ovaries, meningitis, encephalitis, pancreatitis, and permanent hearing loss
  • Vaccination protects against mumps infection and mumps complications

Read full article on mumps.


Bacterial pharyngitis

Bacterial pharyngitis
Image by: en:User:RescueFF [Public domain], via Wikimedia Commons
  • Bacterial pharyngitis is inflammation in the back of the throat caused by a bacterial or viral infection
  • It causes a sore, dry, or scratchy throat accompanied by other symptoms such as fever, chills, body aches, nasal congestion, swollen lymph nodes, headache, cough, fatigue, or nausea
  • The duration of symptoms depends on the cause of the infection

Read full article on bacterial pharyngitis.


Throat cancer

Throat cancer
Image by: James Heilman, MD [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], from Wikimedia Commons
  • This encompasses cancer of the voice box, the vocal cords, and other parts of the throat, such as the tonsils and oropharynx
  • It may occur in the form of squamous cell carcinoma or adenocarcinoma
  • Symptoms include voice changes, difficulty swallowing, weight loss, sore throat, cough, swollen lymph nodes, and wheezing
  • It’s most common in people with a history of smoking, excessive alcohol use, vitamin A deficiency, exposure to asbestos, oral HPV, and poor dental hygiene

Read full article on throat cancer.


Actinic keratosis

Actinic keratosis
  • Typically less than 2 cm, or about the size of a pencil eraser
  • Thick, scaly, or crusty skin patch
  • Appears on parts of the body that receive a lot of sun exposure (hands, arms, face, scalp, and neck)
  • Usually pink in color but can have a brown, tan, or gray base

Read full article on actinic keratosis.


Basal cell carcinoma

Basal cell carcinoma
  • Raised, firm, and pale areas that may resemble a scar
  • Dome-like, pink or red, shiny, and pearly areas that may have a sunk-in center, like a crater
  • Visible blood vessels on the growth
  • Easy bleeding or oozing wound that doesn’t seem to heal, or heals and then reappears

Read full article on basal cell carcinoma.


Squamous cell carcinoma

Squamous cell carcinoma
  • Often occurs in areas exposed to UV radiation, such as the face, ears, and back of the hands
  • Scaly, reddish patch of skin progresses to a raised bump that continues to grow
  • Growth that bleeds easily and doesn’t heal, or heals and then reappears

Read full article on squamous cell carcinoma.


Melanoma

Melanoma
  • The most serious form of skin cancer, more common in fair-skinned people
  • Mole anywhere on the body that has irregularly shaped edges, asymmetrical shape, and multiple colors
  • Mole that has changed color or gotten bigger over time
  • Usually larger than a pencil eraser

Read full article on melanoma.


Rubella

Rubella
Image attribution: [Public domain], via Wikimedia Commons
  • This viral infection is also known as German measles
  • A pink or red rash begins on the face and then spreads downward to the rest of the body
  • Mild fever, swollen and tender lymph nodes, runny or stuffy nose, headache, muscle pain, inflamed or red eyes are some symptoms
  • Rubella is a serious condition in pregnant women, as it may cause congenital rubella syndrome in the fetus
  • It’s prevented by receiving normal childhood vaccinations

Read full article on rubella.


Cat-scratch fever

Cat-scratch fever
  • This disease is contracted from the bites and scratches of cats infected with Bartonella henselae bacteria
  • A bump or blister appears at the bite or scratch site
  • Swollen lymph nodes near the bite or scratch site Low fever, fatigue, headache, body aches are some of its symptoms

Read full article on cat-scratch fever.

Where neck lumps come from

A lump in the neck can be hard or soft, tender or non-tender. Lumps can be located in or under the skin, as in a sebaceous cyst, cystic acne, or lipoma. A lipoma is a benign fatty growth. A lump may also come from tissues and organs within your neck.

Where the lump originates plays an important role in determining what it is. Because there are many muscles, tissues, and organs near the neck, there are many places neck lumps can originate, including:

  • the lymph nodes
  • the thyroid gland
  • parathyroid glands, which are four small glands located behind the thyroid gland
  • recurrent laryngeal nerves, which enable movement of the vocal cords
  • neck muscles
  • the trachea, or windpipe
  • the larynx, or voice box
  • cervical vertebrae
  • nerves of the sympathetic and parasympathetic nervous system
  • the brachial plexus, which is a series of nerves that supply your upper limbs and trapezius muscle
  • salivary glands
  • various arteries and veins

Common underlying causes of neck lumps

An enlarged lymph node is the most common cause of a neck lump. Lymph nodes contain cells that help your body fight off infections and attack malignant cells, or cancer. When you’re sick, your lymph nodes can become enlarged to help fight the infection. Other common causes of enlarged lymph nodes include:

  • ear infections
  • sinus infections
  • tonsillitis
  • strep throat
  • dental infections
  • bacterial infections of the scalp

There are other illnesses that can cause a neck lump:

  • Autoimmune diseases, cancer, and other disorders of the thyroid gland, such as goiter due to iodine deficiency, can cause enlargement of part or all of your thyroid gland.
  • Viruses, such as mumps, can make your salivary glands enlarged.
  • Injury or torticollis can cause a lump in your neck muscles.

Cancer

Most neck lumps are benign, but cancer is a possible cause. For adults, the chance that a neck lump is cancerous increases after the age of 50, according to the Cleveland Clinic. Lifestyle choices, such as smoking and drinking, can also have an impact.

Prolonged use of tobacco and alcohol are the two greatest risk factors for cancers of the mouth and throat, according to the American Cancer Society (ACS). Another common risk factor for cancers of the neck, throat, and mouth is a human papillomavirus (HPV) infection. This infection is generally transmitted sexually, and it’s very common. The ACS states that signs of an HPV infection are now found in two-thirds of all throat cancers.

Cancers that show up as a lump in the neck could include:

  • thyroid cancer
  • cancers of the head and neck tissues
  • Hodgkin’s lymphoma
  • non-Hodgkin’s lymphoma
  • leukemia
  • other types of cancer, including lung, throat, and breast cancer
  • forms of skin cancer, such as actinic keratosis, basal cell carcinoma, squamous cell carcinoma, and melanoma

Viruses

When we think of viruses, we commonly think of the common cold and the flu. However, there are plenty of other viruses that can infect humans, many of which can cause a lump in the neck. These include:

  • HIV
  • herpes simplex
  • infectious mononucleosis, or mono
  • rubella
  • viral pharyngitis

Bacteria

A bacterial infection can cause neck and throat problems, leading to inflammation and a neck lump. They include:

  • infection from atypical mycobacterium, a type of bacteria most common in people with compromised immune systems and lung disease
  • cat scratch fever
  • peritonsillar abscess, which is an abscess on or near the tonsils
  • strep throat
  • tonsillitis
  • tuberculosis
  • bacterial pharyngitis

Many of these infections may be treated with prescription antibiotics.

Other possible causes

Neck lumps might also be caused by lipomas, which develop under the skin. They may also be caused by a branchial cleft cyst or thyroid nodules.

There are other, less common causes of neck lumps. Allergic reactions to medication and food can cause neck lumps. A stone in the salivary duct, which can block saliva, can also cause a neck lump.

Other symptoms associated with a neck lump

Because a neck lump can be caused by such a variety of conditions and diseases, there can be many other related symptoms. Some people will have no symptoms. Others will have some symptoms related to the condition that’s causing the neck lump.

If your neck lump is caused by an infection and your lymph nodes are enlarged, you might also have a sore throat, difficulty swallowing, or pain in the ear. If your neck lump is blocking your airway, you might also have trouble breathing or sound hoarse when you speak.

Sometimes people with neck lumps that are caused by cancer have skin changes around the area. They may also have blood or phlegm in their saliva.

What to expect when you visit your healthcare provider

Your healthcare provider will likely want to ask you about your health history, including details about your lifestyle habits and your symptoms. Your healthcare provider will want to know how long you’ve been smoking or drinking and how much you smoke or drink on a daily basis. They’ll also want to know when your symptoms started and how severe they are. This will be followed by a physical exam.

During the physical exam, your healthcare provider will carefully examine your:

  • scalp
  • ears
  • eyes
  • nose
  • mouth
  • throat
  • neck

They will also look for any abnormal skin changes and other related symptoms.

Diagnosing a neck lump

Your diagnosis will be based on your symptoms, history, and the results of the physical exam. In some cases, your healthcare provider may refer you to an ear, nose, and throat (ENT) specialist for a detailed evaluation of those body parts as well as your sinuses.

The ENT specialist may perform an oto-rhino-laryngoscopy. During this procedure, they’ll use a lighted instrument to see areas of your ears, nose, and throat that aren’t otherwise visible. This evaluation doesn’t require general anesthesia, so you’ll be awake during the procedure.

Your healthcare provider and any specialist may run a variety of tests to determine the cause of your neck lump. A complete blood count (CBC) can be performed to evaluate your overall general health and provide insight into a number of possible conditions. For instance, your white blood cell (WBC) count may be high if you have an infection.

Other possible tests include:

  • sinus X-rays
  • chest X-ray, which allows your healthcare provider to see if there’s a problem in your lungs, trachea, or chest lymph nodes
  • ultrasound of the neck, which is a noninvasive test that uses sound waves to evaluate neck lumps
  • MRI of the head and neck, which makes detailed images of the structures in your head and neck

How to treat a neck lump

The type of treatment for a neck lump depends on the underlying cause. Lumps caused by bacterial infections are treated with antibiotics. Treatment options for cancer of the head and neck include surgery, radiation, and chemotherapy.

Early detection is the key to successful treatment of the underlying cause of a neck lump. According to the American Academy of Otolaryngology — Head and Neck Surgery, most cancers of the head and neck can be cured with few side effects if they’re detected early.

Outlook

Neck lumps can happen to anyone, and they’re not always signs of a serious health issue. However, if you have a neck lump, it’s important to see your healthcare provider to be sure. Like all illnesses, it’s better to get a diagnosis and treatment as early as possible, especially if your neck lump does turn out to be caused by something serious.


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