Knot or Lump in the Neck: What to Know

Neck lumps may be tender or painless and can appear in the skin, muscles, salivary glands, thyroid or lymph nodes. A recent cold, sore throat, dental problem or skin infection can enlarge nearby lymph nodes. A thyroid lump is usually felt lower in the front of the neck, while a lump under the jaw may involve a salivary gland or lymph node.

Head and neck cancer, lymphoma and thyroid cancer can present with a neck lump, but a lump does not by itself identify its cause. Cancer of unknown primary may be considered when a lymph node contains cancer cells but the starting site is not yet found. Examination, ultrasound or other imaging, and sometimes a needle biopsy help clarify the diagnosis.

Arrange a clinical assessment if the lump persists, grows, feels hard or fixed, returns repeatedly, or has no clear link to a recent infection. Note when it appeared, whether it changes with illness, and any hoarseness, swallowing difficulty, ear pain, night sweats or unexplained weight change. Do not squeeze or repeatedly press it.

The clinician may examine your mouth, throat, thyroid and lymph-node areas, then choose tests based on the location and findings. These can include ultrasound, blood tests, a scan or tissue sampling. Treatment depends on the cause; thyroid removal surgery is used only when a thyroid condition and the surgical plan make it appropriate.

Get urgent help if the lump is accompanied by difficulty breathing, inability to swallow saliva, rapidly increasing swelling, severe infection symptoms, new weakness or sudden confusion. Seek prompt medical review for persistent hoarseness, coughing blood, unexplained bleeding or a lump that is quickly enlarging.

Where is the lump arising from? Does it feel like a lymph node, thyroid nodule or another structure? Which examination or scan is needed first? When would biopsy be considered? Which changes should make me contact you sooner?