Neck Lumps: Common ENT Concerns and Symptoms

Questions about the neck?

Hello Dr.
Lee,
When I was 4 to 5 years old, I had an oval-shaped mass in the middle of my right neck that felt soft and movable.
Although the mass was not very large, it was visibly protruding.
My mother took me to see a doctor at that time, but the doctor did not specify what the mass was, only advising to observe it and that it was fine as long as it did not continue to grow.
I would like to ask Dr.
Lee the following questions:
Q1.
Based on my age (4 to 5 years old) and the description of the mass, what do you think is the most likely issue? For example, could it be unilateral lymphadenopathy?
Q2.
As I grew older and my neck became thicker, the noticeable mass on the right side of my neck has disappeared.
However, when I touch the middle sides of both sides of my neck simultaneously, I feel that the middle of the right side is slightly more swollen than the left.
Therefore, I can't help but wonder if the neck mass I had at 4 to 5 years old still exists today.
If the neck mass at that time was lymphadenopathy, is it possible that this lymph node has remained enlarged and has not decreased in size or disappeared after several decades?
Q3.
Is it normal for lymph nodes on both sides of the neck to be symmetrical and of equal size? Or is it possible for the lymph nodes on the left and right sides of the neck to be asymmetrical and of different sizes? For example, in my case, could it be that the lymph node on the right side of my neck was "congenitally" larger than that on the left side?
Q4.
Recently, I have experienced some cold-like symptoms, including: a sore on my left lip (which I accidentally bit), yellow thick nasal discharge, itching and slight discomfort in my throat, and a 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 a slight soft movable lump in the middle of my right neck, although it is not very prominent; the left side of my neck does not have these symptoms.
As far as I know, when cold symptoms appear, the lymph nodes in the neck may become enlarged, but in my case, I only feel lymphadenopathy on the right (unilateral) side of my neck, with no enlargement on the left side.
Dr.
Lee, is it normal for only one side of the lymph nodes to be enlarged during a cold?
Thank you, Dr.
Lee.

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

Dr. Li Jiaxuan reply Otolaryngology

On both sides of the neck, along the sternocleidomastoid muscle, there are hundreds of lymph nodes, each typically measuring less than 0.7 centimeters under normal conditions.
Sometimes, multiple nodes may cluster together, making them feel larger upon external palpation.
The distribution of lymph nodes on the left and right sides is usually not the same.
Additionally, children have thinner skin, which often makes it easier to observe enlarged lymph nodes.
However, to confirm a diagnosis, ultrasound examination followed by fine-needle aspiration and pathological diagnosis is usually performed.
If you are concerned about any issues with your lymph nodes, you can visit a medical facility for evaluation.
Wishing you good health.

Reply Date: 2024/04/05

More Info

Hello! Thank you for your detailed questions regarding the neck lump and associated symptoms. I will address each of your queries based on common medical knowledge and practices in the field of otolaryngology (ENT).

Q1: What could the neck lump have been at the age of 4-5?
Given your description of a soft, movable, oval-shaped lump in the neck at such a young age, it is quite possible that it was a lymph node. In children, lymph nodes can become enlarged due to various reasons, including infections (viral or bacterial), which are common in young children. The fact that it was soft and movable is typically a good sign, suggesting it was likely reactive lymphadenopathy rather than a more serious condition.

Q2: Can lymph nodes remain enlarged for decades?
If the lump you experienced was indeed an enlarged lymph node, it is possible for lymph nodes to remain palpable even after the initial cause has resolved. Lymph nodes can sometimes become fibrotic or scarred after prolonged inflammation or infection, leading to a persistent but non-problematic enlargement. However, if you notice any changes in size, consistency, or if you develop new symptoms, it would be prudent to consult a healthcare provider for further evaluation.

Q3: Are lymph nodes always symmetrical in size?
Lymph nodes are not always symmetrical in size. It is quite common for individuals to have slight variations between the left and right sides of the neck. Some people may have naturally larger lymph nodes on one side due to genetic factors or previous infections. Therefore, your observation of a slightly larger right-sided lymph node is not unusual and may not indicate any underlying pathology.

Q4: Is it normal for only one side of the neck to show lymph node enlargement during a cold?
Yes, it is entirely possible for only one side of the neck to exhibit lymph node enlargement during an illness such as a cold. Lymph nodes react to infections in the area they drain. For instance, if you have a sore throat or a localized infection, the lymph nodes on that side may become enlarged while the opposite side remains unaffected. The symptoms you described, including a sore throat, nasal discharge, and the presence of a movable lump on the right side, could indicate that your body is responding to an infection, and the right-sided lymph node is reacting accordingly.

Additional Considerations
Given your recent symptoms, including a sore throat and nasal congestion, it would be wise to monitor your condition. If the lump persists, increases in size, or if you develop additional symptoms such as fever, night sweats, or unexplained weight loss, you should seek medical attention. A healthcare provider may recommend imaging studies, such as an ultrasound or CT scan, to evaluate the lymph node further if deemed necessary.

In summary, while your experiences with the neck lump and associated symptoms can be concerning, many factors can contribute to these findings. It is essential to maintain open communication with your healthcare provider, who can offer personalized advice and treatment options based on your specific situation. Thank you for your questions, and I hope this information helps clarify your concerns!

Similar Q&A

Understanding Lumps Near the Jaw: Causes and Concerns for Ear and Throat Issues

Dear Dr. Cheng, Two weeks ago, I woke up to find a "sudden lump about 2-3 cm" at the junction of my right jaw and the back of my neck, approximately 3 cm below my right ear. It feels movable and firm to the touch. I initially suspected it might be a large pimple on my ...

Dr. Zheng Jueyi reply Otolaryngology
Dear Ah Kai, Based on the symptoms you described, it appears that you may be experiencing lymphadenopathy. The most common causes are infections in the head and neck region, such as infections of the ear or teeth. An endoscopic examination typically only requires entry through o...

Understanding Neck Lumps: When to Seek ENT Evaluation

Hello, doctor. I have found a lump near the upper part of my neck close to my chin (located towards the center). It is not very mobile, approximately 1 to 2 centimeters in size, and has been present for a while without significant changes in size. I discovered it by chance, so I ...

Dr. Ji Zhaoyun reply Otolaryngology
Hello, it is advisable to consult an otolaryngologist if you continue to feel a lump in your neck. It could potentially be enlarged lymph nodes, a congenital cyst, acute or chronic inflammation, or even a malignant tumor, among other possibilities. Wishing you peace and good heal...

Understanding Nasopharyngeal Cancer Symptoms and Thyroid Nodules

What are the symptoms of nasopharyngeal carcinoma? Is there a possibility of a lump, and if so, where is it located? Additionally, regarding the small lump near the neck that a doctor mentioned could be related to the thyroid, is that correct?

Dr. Chen Jianzhi reply Otolaryngology
Dear Mr. Lai, The symptoms of nasopharyngeal carcinoma include neck masses, diplopia, middle ear effusion, headaches, and epistaxis. Among these, neck masses are the most significant symptom, typically located in the lateral neck region. Given that there are numerous potential c...

Understanding Neck Lumps: Causes and Concerns in ENT Health

Hello Doctor: Recently, I have noticed a sensation of a foreign body in my left throat while swallowing, which is not painful. The symptoms are accompanied by a mild cough, phlegm in the throat, nasal congestion, tinnitus, and fever (the nasal congestion has been fluctuating for ...

Dr. Zheng Jueyi reply Otolaryngology
Hello! If a neck mass has already been examined by an otolaryngologist and undergone endoscopic evaluation, it is mostly likely a benign change, possibly normal submandibular gland tissue. However, if it continues to enlarge, further medical evaluation is necessary. Wishing you h...