Wednesday January 23, 2013
Lump in the neck
Tell Me About ...
By Dr Y.L.M
A lump in the neck may signify a great many things.
MY mother recently discovered a lump in the side of her neck. Naturally, she is very worried. What can a lump in the neck be due to?
There are many causes of neck lumps. The causes can also be derived from where the lump is – right side of the neck, left side of the neck, in the midline, below the jaw, etc. You also have to think about the different layers in your neck.
There are many structures within your neck. Outermost is the skin, subcutaneous tissue, muscles, arteries, veins and nerves.
A very important artery in the neck is the carotid artery. Its accompanying vein is the jugular vein.
There are also the lymph nodes that form part of your lymphatic system.
Then there are structures within the neck, such as the salivary glands – the sublingual, the parotid and submandibular pairs of glands. There’s the thyroid gland and the lymph nodes. There’s the pharynx and larynx (voice box) and trachea.
Then there are the bones that support the neck – your cervical spine, all seven vertebrae.
Many of these structures can give rise to a lump in your neck.
What are the most frequent causes of lumps in the neck?
Most people fear cancer when they see a lump in their neck. But rest assured that most neck lumps are not cancer.
Enlarged lymph nodes are the most frequent cause. These are usually caused by infections: bacterial, viral, and also, more ominously, cancer.
Other more common causes of neck lumps include enlargement of the salivary glands under the jaw, also either by infection (eg mumps) or cancer. Lumps that are under the skin or in the skin are usually cysts, including sebaceous cysts.
Lumps in the neck muscles are usually caused by injury. The thyroid gland also may give rise to a lump or multiple lumps. This is not necessarily thyroid cancer, though it should always be suspected.
Say that my lump is due to an enlarged neck lymph node. What should I do?
Most enlarged lymph nodes are due to exposure to a bacteria or virus. These may be painful and tender, and range in size from that of a pea, or even larger.
The doctor will ask you for other symptoms that accompany this enlarged lymph node. If you have an infection, there may be fever, flu-like symptoms or a sore throat and runny nose. If you have an upper respiratory tract infection, this may affect the lymph nodes in your neck.
If your neck lymph node is not the only enlarged one, and there are other enlarged lymph nodes in your body, this may signal a more generalised disease affecting the entire body.
Generalised body lymph node enlargement could be due to a widespread infection such as HIV, an immune disease such as lupus or rheumatoid arthritis, or cancer such as Non-Hodgkin’s lymphoma.
Since most enlarged lymph nodes are due to an infective and benign cause, they will resolve when your infection goes away.
However, if you are worried, you should see a doctor. You should definitely see a doctor if the lymph node:
*Continues to enlarge
*Is still there after two weeks
*Feels hard and rubbery
*Feels very immobile
*Is accompanied by persistent fever, sweating at night or weight loss
*Causes difficulty in swallowing or breathing
Must a biopsy be taken? I’m scared.
If the doctor suspects that the enlarged lymph node is due to more than just infection, he or she may suggest a biopsy. Most lymph node biopsies are done via a fine needle. It will only hurt like a simple injection or blood taking, so don’t worry.
The specimen will then be sent to the lab. Treatment will depend on the cause of the enlarged lymph node, which will be identified by the biopsy results.
What is lymphoma? That is actually the disease I am afraid of getting.
Lymphoma is a type of immune system cancer. Here, the lymphocyte – your white cell that is associated with producing antibodies and defending your body against foreign attack – is affected.
The lymphocytes go out of control and multiply. They then accumulate in your lymph nodes and spleen and tonsils, forming a tumour that grows larger and larger.
There are two types of lymphoma: Hodgkin’s disease and Non-Hodgkin’s lymphoma. They have similar symptoms.
Can lymphoma be cured?
There are many subtypes of lymphoma. Some of them are aggressive, and others are slow to proliferate and grow. Some of them can indeed be cured with targeted therapies, especially aggressive Non-Hodgkin’s lymphoma.
Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health advice, computers and entertainment. For further information, e-mail email@example.com. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.