Neck Lumps: Common Concerns in ENT Health

Inquiry for clarification?

Hello Dr.
Cheng, I would like to ask you a few questions as follows:
1) When I was about 4 to 5 years old, I had an oval-shaped mass in the middle of my right neck that felt soft and movable.
The mass was not very large, but it was clearly visible.
My mother took me to see a doctor, who did not specify what the mass was but suggested monitoring it, stating that it was fine as long as it did not continue to grow.
Based on my age and the description of the mass, what do you think it could have been? Could it have been a unilateral lymphadenopathy?
2) Following up on the previous question, as an adult, I no longer see a noticeable mass on the right side of my neck, possibly due to the growth of my neck.
However, I feel that when I touch the middle sides of both sides of my neck, the right side feels slightly more swollen than the left, leading me to wonder if the mass I had at 4 to 5 years old still exists.
If the mass was indeed lymphadenopathy, is it possible for it to remain enlarged for several decades without decreasing in size?
3) Generally speaking, are the lymph nodes on both sides of the neck supposed to be symmetrical and of equal size? Or is it possible for the lymph nodes on the left and right sides to be asymmetrical and of different sizes? For example, could the lymph nodes on the right side of the neck be "congenitally" larger than those on the left side?
4) Recently, I have experienced symptoms similar to a cold, including a sore on my left lip (which I accidentally bit), yellowish thick nasal discharge, slight itchiness and discomfort in my throat, and a mild headache.
Today (April 5), I noticed that the middle of my right neck feels more swollen than the left, and when I tilt my head to the left and straighten my right neck, I can feel what seems to be a soft, movable mass in the middle of my right neck, although it is not very prominent.
There are no such symptoms on the left side.
I understand that lymph nodes may become enlarged during a cold, but is it normal for only the lymph nodes on the right side of my neck to be swollen while the left side remains unaffected?
Thank you, Dr.
Cheng.

Kris, 40~49 year old female. Ask Date: 2024/04/05

Dr. Zheng Jueyi reply Otolaryngology

Hello, 1) Commonly, it may be lymph nodes.
2) It cannot be determined.
3) The lymph nodes on the left and right sides of the neck may not necessarily be symmetrical or of the same size; there may be slight differences.
4) Infections can cause lymphadenitis, leading to swollen lymph nodes.
If you are concerned or if there is persistent swelling and pain in the neck, it is recommended to consult an otolaryngologist for examination and confirmation.

Reply Date: 2024/04/05

More Info

Dear Patient,
Thank you for your detailed questions regarding your concerns about neck lumps and related symptoms. It’s important to address these issues comprehensively, as they can often be indicative of underlying health conditions. Let’s break down your questions one by one.

1. Childhood Neck Lump: The soft, movable, oval-shaped lump you described at the age of 4-5 years is likely a benign lymph node enlargement. In children, it is common for lymph nodes to swell in response to infections, and they can often be palpable. If the lump was not painful and did not grow significantly, it was reasonable for your physician to recommend observation. Many childhood lymph nodes can resolve on their own as the child grows and their immune system matures.

2. Adult Perception of Neck Lump: It’s not uncommon for individuals to perceive asymmetry in their bodies, especially in areas like the neck where lymph nodes can vary in size. If the lump you felt as a child was indeed a lymph node, it is unlikely that it has remained enlarged for decades without any change. Lymph nodes typically shrink back down after the infection or inflammation resolves. However, if you feel a difference in size now, it could be due to natural anatomical variations or changes in your body over time.

3. Symmetry of Lymph Nodes: Lymph nodes are not always symmetrical. It is entirely possible for one side of the neck to have larger or more prominent lymph nodes than the other. This can be due to various factors, including previous infections, genetic predispositions, or even anatomical variations. If one side is consistently larger, it may warrant further investigation, especially if accompanied by other symptoms.

4. Recent Symptoms and Right-Sided Swelling: Your recent symptoms, including a cold, sore throat, and the swelling of the right-sided lymph node, suggest that your body is responding to an infection. It is common for lymph nodes on the side of the body where an infection is present to swell. The fact that only the right side is affected can be normal, especially if the infection is localized. However, if the swelling persists or is accompanied by other concerning symptoms (such as fever, night sweats, or unexplained weight loss), it would be prudent to seek further evaluation.

In conclusion, while many of your concerns can be attributed to benign conditions, it is essential to monitor any changes in size, consistency, or associated symptoms of the lymph nodes. If you notice persistent swelling, pain, or any new symptoms, I recommend consulting with an ENT specialist for a thorough examination and possibly imaging studies, such as an ultrasound, to assess the lymph nodes further.

Thank you for your questions, and I hope this information provides clarity and reassurance regarding your health concerns. Please feel free to reach out if you have any further questions or need additional guidance.

Best wishes for your health,
Dr. Zheng

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