A Lump in the Neck

Dr. Mark Singer, a noted head and neck surgeon in San Francisco, describes in straight-forward terms what to do when a lump is discovered in the neck. There are several possible causes —infection, inflammation, a remnant of a cyst from the time of birth as well as cancer. Depending upon where in the neck the lump is as well as the lump’s characteristics (size, location in the neck, hardness and tenderness), the person’s age, the possible history of a sore throat a few weeks earlier, a history of smoking and many other factors, physicians can prioritize which of the several causes are most likely. Often a trial of antibiotics is appropriate. There is also a simple, painless procedure to place a small needle into the lump that can identify the cause. Cells can be evaluated under the microscope and cultures can be taken as well through the needle. Tumor cells and often the type of tumor can also be identified, an important issue for some patients. The procedure is called an FNA for fine needle aspirate.