HEAD AND NECK LUMPS

“Having a neck lump can be a worrying time and you need the reassurance of an expert. I am very experienced in the diagnosis and management of lumps that can develop on the head and neck. Neck lumps have many causes and we aim to diagnose the cause very quickly so that you can get effective treatment without delay.“


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Diagnosing your head or neck lump

During your initial appointment Mr Hodges will take a detailed history and examination of the lump and you will then have a series of tests so that we can narrow down the reason for the lump and give you a firm diagnosis.

Mr Hodges is skilled at treating neck lumps. This may include:

  • Reassuring you that the lump is a just normal part of your body.
  • Monitoring the lump as it is not harmful and it will go away with time.
  • Removing the lump to allow further tests to be undertaken.
  • Removing the lump to cure the disease.
  • Treating the underlying disease, by removing an infected wisdom tooth for example.
  • On occasion the nature of the neck lump warrants treatment by another specialist. Mr Hodges will arrange a referral if necessary and follow your progress closely.

Having neck surgery

The neck is a complex area to operate on as it contains large blood vessels and important nerves. Plus it has important structures such as the voice box, salivary glands and thyroid gland that need to retain their function.

Mr Hodges will use small incisions and will try to hide the external scar in a natural skin crease. Careful surgery will minimize complications and reduce the recovery time. Stitches are usually hidden and dissolve over a few weeks so that your scar will be as small as possible

What can cause neck lumps?

A swollen lymph node

The body has around 600 lymph nodes in the body and about 200 of these are in your neck. Lymph nodes filter the lymph, fluid that is found in the lymphatic system, which helps to return tissue fluid to the blood. Lymph notes can enlarge for many reasons, the most common being in response to an infection. Swollen lymph nodes can sometime also be a sign of cancer.

Swollen salivary glands

You have three pairs of major salivary glands; the parotid, submandibular and sublingual salivary glands. A range of conditions can affect these glands and cause lumps within the head and neck. Salivary glands usually swell due to infections, stones and tumours. All can be treated effectively and a rapid diagnosis means early treatment.

An enlarged thyroid gland

The thyroid gland is situated at the front and lower portion of the neck. The thyroid gland can become enlarged for several reasons:

  • Iodine deficiency
  • Thyroid cysts
  • Grave’s disease
  • Hashimoto’s disease
  • Pregnancy
  • Solitary nodules
  • Multinodular goitre
  • Thyroid tumours – benign and cancerous

Cysts

Cysts are a common cause of lumps in the head and neck region. Cysts take many forms but most are not cancerous and can be easily removed. Cysts that can occur on the head or in the neck include:

  • Sebaceous skin cysts
  • Branchial cysts
  • Thyroglossal duct cysts
  • Dermoid cysts
  • Salivary gland cysts
  • Cystic degeneration in a lymph node

Cancers

Cancers can cause neck lumps usually by causing enlargement of the lymph nodes. Lymphomas and different types of leukaemia can also cause swollen lymph nodes. Other cancers that start in other parts of the body may spread to the lymph nodes and cause swollen glands.

The most common cancers that spread to the neck lymph nodes are mouth cancers, throat cancers and skin cancers. Less commonly, lung, breast and gastrointestinal cancers can also spread to the neck.

Tests used to diagnose neck lumps

We have a range of tests at our disposal to find out what type of neck or head lump you have. The first set of tests involve imaging the lump from outside the body, so are classed as non-invasive tests:

  • spencer-hodges-ultrasound-imaging-for-diagnosis
    Mr Hodges about to perform an ultrasound scan during diagnosis

    An ultrasound scan – this simple test uses ultrasound to examine the lump. The scan is painless and involves having a small sensing device moved across the skin around the lump. The scan can reveal how dense the lump is and if it is attached to underlying tissue.

  • A CT scan – this can show the body in slices and in three dimensions, which makes it a very tool to find out more about the inside of a lump. The scan can also take accurate measurements and these can be used later if surgical removal is necessary.
  • An MRI scan – This is a very good imaging technology for looking at soft tissues within the body and therefore is regularly used for head and neck lumps. It is very accurate and can show incredible detail.
  • A dental panoramic tomogram (DPT) – this is a type of X-Ray that shows the jaws, teeth and surrounding structures very well. Mr Hodges will recommend this type of imaging if he suspects that a neck lump is due to an infected wisdom tooth, for example.

We can also arrange tests that involve taking samples of fluid, cells, blood or tissue:

  • A fine needle aspiration– a very fine needle is used to remove a sample of cells from the lump so that they can be looked at using a microscope. It can show if cancer cells are present or if a lump is mainly fluid with a few white blood cells.
  • Blood tests – it is possible to test to find a huge amount of information about what is happening inside your body and blood tests are used routinely to help diagnose head and neck lumps.
  • Lymph node excision – on occasion the whole lymph node needs to be removed to allow the pathologist to look at it in much more detail. This can give a lot of information to help plan treatment especially in conditions such as lymphoma.