Causes of Lumps on the Neck

Most often, a neck lump is due to a swollen lymph node—a tiny cluster of cells that help the immune system fight off invaders, such as viruses. When this happens, the lymph nodes can swell. A neck lump or nodule can also be caused by a cyst, lipoma, boil, or goiter.

Finding a lump in or on your neck may immediately have you wondering if it's a cancerous tumor. While that's one possibility, it's important to know that there are many causes of neck lumps—some of which are concerning, some of which are not.

This article discusses common causes of a lump in your neck, including reasons for swollen lymph nodes. You will also learn how to tell the difference between swollen lymph nodes and other types of lumps in your neck, such as cysts, goiters, and tumors.

Swollen Lymph Nodes

One of the most common reasons you'd feel a lump in your neck is because you're actually feeling your lymph nodes. Lymph nodes are found in the neck, face, armpits, chest, abdomen, and groin.

A fluid called lymph, which contains white blood cells (lymphocytes) that fight infection, flows through the lymphatic system. Lymph also carries bacteria, viruses, and other germs away from your tissues, all of which is filtered through your lymph nodes.

If you have an active infection, the lymph nodes can get bigger as they work to help rid your body of the illness. When you get better, they'll go back to their normal size.

A swollen lymph node feels like a small, soft bump under the skin. These nodes can range in size from a pea to a grape, often feel tender to the touch, and can be uncomfortable.

Infection is the most common cause of swollen lymph nodes. Some illnesses that can be to blame include:

• Dental infections
• Common cold
• Flu
  
• Tonsillitis
  
• Strep throat
• Mononucleosis (also called "mono")
  
• Cytomegalovirus (a type of herpes virus)
• HIV

Less often, swollen lymph nodes are caused by cancer, especially ​non-Hodgkin lymphoma. Cancers can also spread to lymph nodes and cause them to get big and hard. The lymph nodes may also not move well (what providers call "fixed" or "non-mobile").

Enlarged lymph nodes can also be caused by immune system disorders, such as rheumatoid arthritis.

Checking Lymph Nodes for Swelling

If your lymph nodes are swollen, you can often feel them by pressing lightly and circling your three middle fingers in these places:

• Behind the ears and under the jawline
• On both sides of the back of your neck
• From the middle of your armpit to the side of your breast
• Along the crease where the thigh meets the pelvis

Only a healthcare provider can determine if your neck lump is a swollen lymph node or something else.

Nodules

A nodule is an abnormal growth of tissue anywhere in the body. Most cases are not cancerous.

You should note, however, that healthcare providers will often call a neck lump a nodule until they know exactly what it is—which means that a nodule, once tested, could end up being cancerous.

Whether a nodule needs to be treated depends on if it's causing symptoms, if or how quickly it is growing, and where it is on the body.

Cysts

Lumps in your neck can also be cysts. Cysts are fluid-filled sacs of tissue. They can form almost anywhere in the body. A cyst is not solid and usually feels soft. Cysts are often benign, but some cancers can be cystic.

Many cysts go away on their own. However, depending on their size and location, they may have to be surgically drained.

Lipomas

A lipoma is a benign lump filled with fat. If you feel a lump in your neck, it could be a lipoma.

Lipomas are not cancerous. (Fatty tumors that are cancerous are very rare and are called liposarcomas.) They may have to be surgically removed depending on their size and location. People who have had one lipoma or a family history of lipomas are more likely to get them again.

Goiters or Colloid Nodular Goiters

Another common reason for feeling a lump in your neck is that you have a goiter, which simply means an enlarged thyroid gland. Nodular goiters are lumps on an enlarged thyroid gland. They appear in the front of the neck, often just on one side.

Since your thyroid moves up and down when you swallow, any goiters and lumps on the thyroid will also move.

Goiters often point to a problem with thyroid function, but they can also appear if you have normal thyroid function.

Goiters can usually be treated with medication. For example, having too little thyroid hormone (hypothyroidism) can be treated with Synthroid (levothyroxine), and having too much thyroid hormone (hyperthyroidism) can be treated with radioactive iodine.

In some cases, goiters have to be surgically removed.

Boils

Sometimes, neck lumps are related to infections. Boils are skin infections that can look and feel like lumps. They can form anywhere on the body but tend to be close to the surface of the skin. Boils can be deep, hard, and fairly big. Pus may come out of them.

Boils can be drained by a healthcare provider. Sometimes, antibiotics are also needed—either put on the skin (topical) or taken by mouth as a pill. In severe cases, intravenous (IV) antibiotics might be needed to treat a boil.

Sometimes boils have to be drained by a surgeon (a procedure called incision and drainage).

Cancerous Tumors

Cancer cells are mutated cells that grow fast and can be very difficult to stop. There are thousands of ways to classify tumor types.

Cancerous lumps are commonly found in the breast, testicle, or lymph nodes. According to the American Cancer Society, lumps that are fluid-filled and easily rolled in the fingers are less likely to be cancerous than those that are hard, irregular, rooted, and painless.

There are many symptoms of cancer; a visible lump can be one. While it's not not all lumps are cancerous, it can be scary if you notice one. That's why it's important to have your provider take a look.

Should I Be Worried About a Lump on My Neck?

It may be easy to conclude that a neck lump is a swollen lymph node and nothing to worry about—and you may indeed be right. For example, you have a cold, have other related symptoms, frequently experience this when you get sick, and the lump popped up quickly.

Still, the only way to know for sure if your neck lump is worrisome or not is to see a healthcare practitioner.

There are some features of neck lumps that can raise red flags. For example, here's how a cancerous lump differs from a neck lump due to a swollen lymph node:

Any signs of a cancerous lump should prompt a trip to your healthcare provider. You should also get evaluated if your neck lump is persisting, getting larger, or cannot be clearly tied to a recent illness.

Diagnosing a Neck Lump

In some cases, a practitioner can determine if your neck lump is likely a cause for concern based on a physical examination and a review of other symptoms you may be experiencing. For example, if you have mono, you may also have a fever or sore throat.

In others, testing will be needed to finalize the diagnosis.

Testing

If a lump is not obviously due to a swollen lymph node or the practitioner notices features of the lump that are suspicious or undefined, diagnostic imaging tests will likely be done. An ultrasound, X-ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI) can help your provider see whether or not the lump is solid or fluid-filled.

Imaging tests can also measure how big the lump is and sometimes show whether the lump is affecting other organs and tissues nearby.

If the lump is not caused by infection or filled with fluid, your provider might want to perform a biopsy. Sometimes fluid-filled lumps will also be biopsied because they can also be cancerous (for example, if it is cystic thyroid cancer).

For a biopsy, a small amount of tissue is taken from the lump. A tissue sample can usually be taken using a needle, but some have to be taken surgically. Your provider will let you know if and when you need to have a biopsy and the best way to take the tissue.

The sample is then analyzed in a laboratory to see what the lump actually is made of.

Summary

Lumps in your neck are most likely not serious. The most common cause of neck lumps are that your lymph nodes are swollen. This commonly occurs when your body is fighting an infection, such as the flu, mono, or strep throat. As the infection clears up, your swollen lymph nodes should go back to their normal size.

Neck lumps or nodules can also be caused by cysts, boils, lipomas, and goiters. These are not cancerous, but they may need to be surgically drained or removed by a provider.

It's less common, but lumps on the neck can also be a sign of cancer. If the lump is getting bigger or not going away, tell your provider. They can figure out what the lump is and recommend the best way to treat it.