Neck Lumps: Common Concerns and When to Seek Help

Regarding neck lumps?

Hello, Doctor.
I actually inquired about this about a month ago.
I noticed two small lumps on the "left side" of my neck, each about 1 cm in size, and I was very worried.
I visited a hospital and an ENT clinic, where two doctors examined me and performed a nasopharyngoscopy.
They both indicated that I shouldn't be concerned.
However, in the past few days, I accidentally felt a lump on the "right side" of my neck that I hadn't noticed before.
Today, I am very worried and consulted another ENT, who suggested that I should go to a larger hospital to see an "internist." I would like to understand the following:
1.
Why did I not notice the lumps before, and why did they suddenly appear?
2.
If the lumps are due to lymphadenitis caused by a cold, shouldn't they be painful?
3.
The doctors told me not to worry; if it is not caused by a cold or inflammation, what could be the cause?
4.
Once the lumps swell, will they go away? Is it possible that they may not go away and remain palpable?
5.
In my situation, should I see an ENT specialist or an internist?
I hope the doctor can provide me with detailed answers, as I tend to be quite anxious and often worry.
Thank you for taking the time to respond.
I appreciate it.

Mr. Zhou, 20~29 year old female. Ask Date: 2016/05/02

Dr. Zheng Jueyi reply Otolaryngology

Hello, there are many lymph nodes in the neck, which can enlarge due to infections, tumors, or immune system abnormalities.
If the enlargement is caused by an infection, it may decrease in size after medication treatment, but it may not completely disappear to the point of being undetectable.
If a physician has examined you and found no significant abnormalities, it is advisable to continue monitoring.
You may consult either an otolaryngologist or an internist.
Wishing you peace and good health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2016/05/02

More Info

When it comes to understanding neck lumps, it's essential to approach the situation with a clear mind and a comprehensive understanding of the potential causes and implications. Based on your description, you have encountered multiple lumps on both sides of your neck, which has understandably caused you concern. Here’s a detailed response to your questions, along with some additional insights.

1. Why did I not notice the lumps before?
Lumps in the neck can sometimes be subtle and may not be easily felt until they grow larger or change in consistency. Factors such as body position, muscle tension, or even the way you palpate your neck can affect your ability to detect these lumps. Additionally, lymph nodes can swell in response to various stimuli, including infections or inflammation, which may explain why you only recently noticed them.

2. If the lumps are due to a cold, should they be painful?
Typically, swollen lymph nodes due to an infection, such as a cold, can be tender or painful. However, not all swollen lymph nodes are painful. Some may remain asymptomatic, especially if the underlying cause is mild or resolving. If the lumps are indeed lymph nodes reacting to an infection, they may fluctuate in size and tenderness based on your overall health and immune response.

3. If not caused by an infection, what could be the other reasons?
There are several potential causes for neck lumps that are not related to infection. These can include benign conditions such as lipomas (fatty tumors), cysts, or enlarged lymph nodes due to chronic inflammation. In some cases, more serious conditions, such as tumors (benign or malignant), can also present as neck lumps. It’s crucial to have a healthcare professional evaluate these lumps to determine their nature.

4. Will the lumps go away? Can they remain?
The fate of swollen lymph nodes or lumps in the neck largely depends on their underlying cause. If they are due to a transient infection, they may resolve on their own as your body fights off the illness. However, if they are due to a more chronic condition, they may persist. In some cases, lumps can remain palpable even after the underlying issue has resolved, particularly if there has been some fibrous tissue formation.

5. Should I see an ENT specialist or an internist?
Given your situation, it would be prudent to consult with an ENT (Ear, Nose, and Throat) specialist, especially since they have expertise in evaluating neck masses and can perform necessary imaging studies or biopsies if needed. An internist can also provide valuable insights, particularly if there are systemic concerns, but starting with an ENT may be more beneficial in your case.

In conclusion, while it’s natural to feel anxious about new lumps, it’s essential to approach this matter with a level-headed perspective. You have already taken the right steps by seeking medical advice. Continue to monitor the lumps, and if they change in size, consistency, or if you develop new symptoms, return to your healthcare provider for further evaluation. Remember, many neck lumps are benign, and with proper assessment, you can gain peace of mind.

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