Neck Lumps: When to Seek ENT Evaluation and Testing

I have a lump in my neck?

I previously visited National Taiwan University Hospital, but these past few days, I've been experiencing discomfort in my neck, with a feeling of pressure while sleeping.
My energy levels are also low (not sure if there's a connection).
Additionally, I have a sensation of a foreign body in my throat.
I had seen a doctor before regarding this sensation, and the doctor mentioned it was due to lack of exercise.
Recently, I've been carefully examining my neck and it seems like there are new lumps.
Previously, I had lymphadenopathy on the left side of my neck, and there was also swelling under my right armpit, for which I underwent surgery.
Occasionally, I also experience pain near my left chest.
What should I do? If I need to undergo tests, what specific examinations should I consider? Thank you for your assistance.

Guo, 20~29 year old female. Ask Date: 2005/03/21

Dr. Cai Hongyan reply Otolaryngology

Hello! Enlarged lymph nodes in the neck accompanied by pain are most commonly caused by upper respiratory tract infections, and they typically improve with time and recovery from the cold.
However, if the neck lump persists and increases in size, it is important to pay special attention.
It is recommended to visit an otolaryngology clinic for a fine needle aspiration biopsy.
Thank you!

Reply Date: 2005/03/21

More Info

When it comes to neck lumps, particularly those that are persistent or associated with other symptoms, it is crucial to seek evaluation from an Ear, Nose, and Throat (ENT) specialist. Your symptoms, including discomfort in the neck, a feeling of pressure while sleeping, fatigue, and the sensation of an obstruction in your throat, warrant further investigation.
Neck lumps can arise from various causes, including infections, benign tumors, or malignancies. Given your history of previously enlarged lymph nodes in the left side of your neck and the right axilla, it is essential to consider the possibility of recurrent or new lymphadenopathy. Lymph nodes can swell due to infections, autoimmune diseases, or malignancies, and their persistence or change in character should not be overlooked.

In your case, the following steps are advisable:
1. Consultation with an ENT Specialist: Schedule an appointment with an ENT doctor who can perform a thorough examination of your neck and throat. They will assess the size, consistency, and mobility of the lumps and inquire about any associated symptoms, such as fever, night sweats, or weight loss, which could indicate a more serious condition.

2. Imaging Studies: Depending on the findings during your consultation, the ENT specialist may recommend imaging studies. Common imaging techniques include:
- Ultrasound: This is often the first imaging modality used to evaluate neck lumps. It can help differentiate between solid and cystic masses and assess the characteristics of lymph nodes.

- CT Scan or MRI: If the ultrasound findings are inconclusive or if there is a need for more detailed imaging, a CT scan or MRI may be ordered. These can provide a comprehensive view of the neck structures and help identify any underlying issues.

3. Biopsy: If the imaging studies suggest that the lump could be malignant or if there is significant concern, a biopsy may be necessary. This can be done through fine-needle aspiration (FNA) or excisional biopsy, depending on the size and location of the lump. The biopsy will provide definitive information regarding the nature of the lump.

4. Blood Tests: Depending on your symptoms and the findings, your doctor may also recommend blood tests to check for signs of infection, inflammation, or other systemic conditions.

5. Monitoring Symptoms: Keep track of any changes in your symptoms, including the size of the lump, any new lumps, changes in swallowing, or breathing difficulties. This information can be valuable for your healthcare provider.

Given your history of surgery and the presence of multiple lymph nodes, it is essential to approach this situation with caution. While many neck lumps are benign, the presence of persistent or new lumps, especially in the context of systemic symptoms like fatigue, should be evaluated promptly.
In summary, do not hesitate to seek medical attention. An ENT specialist will guide you through the necessary evaluations and tests to determine the cause of your neck lumps and recommend appropriate management. Early diagnosis and intervention can significantly impact outcomes, especially if there is an underlying malignancy or other serious condition.

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