A Lump in the Neck: Common Causes and When to Worry

Most neck lumps are reactive nodes

The neck is full of lymph nodes — small glands that swell when they fight infection. A sore throat, a dental infection, even a scalp wound can raise a tender lump that settles as the infection clears. In children and young adults, this is by far the most common story: the lump is tender, it appeared with an illness, and it shrinks within two to three weeks.

The features that change the picture

• 01It persists beyond two to three weeksAnd is not shrinking
• 02It is painlessInfection hurts; the dangerous lumps often do not
• 03It is hard and fixedA rubbery or stony lump that does not slide under the fingers
• 04It is growingSlowly and steadily, week on week
• 05It comes with other signsA mouth ulcer, hoarseness, difficulty swallowing, one-sided ear pain, weight loss, night sweats
• 06You are an adult tobacco userA persistent painless neck lump in a tobacco user is treated as serious until proven otherwise

How the question gets answered

An examination of the neck, mouth and throat, usually an ultrasound, and — where needed — a fine-needle aspiration: a thin needle takes a sample of cells in minutes, in the clinic, and answers the question definitively. Nobody should live with a persistent unexplained neck lump and the anxiety it carries when the test that settles it is this quick.

Common questions