knot pops out in right side of neck, can pop it back in

[stlablue]

Hi, I am 1.5 years post op gastric bypass and had a central line. Ever since then occasionally I will feel a knot pop out on the right side of my neck in the area of the central line. I attributed the knot to the central line thinking that it weakend a tendon or such. However, when I feel the pop I can feel a hard marble size knot on the right side that I can push or should I say pop back in .When it pops out there is pain along the right side of the neck and jaw. As soon as I pop it back in I feel fine, no pain. The other night this happened and I had a hard time popping it back in. After a while I got it back in. when I woke up I still had neck pain and finally went to my PCP. He felt a slightly enlarged thyroid on palpitation, along with possible muscle strain. I went for a ultrasound of the thyroid and it shows small nodules on the right side and enlarged thryoid on that side. My previous thyroid tests were WNL. The PCP said that the nodules were very small and that when I go for my Px in October he will run some more tests.I have had some difficulty swallowing and continue to have a dull ache on the right side since the incident earlier this week. What other tests should I request when I next speak to my PCP? What are the major concerns? What additional s/sx should I be looking for that something else may be going on? What could I possibly be popping back into my neck?

[John Kenyon, CNA]

Hi there -

Often a central line is in place long enough for scar tissue to form around the site, and this could easily appear as a knot. due to the vessel lying in a groove or channel in your neck, the knot may now have "cured" sufficiently to allow it to work its way out of the channel and to be pushed back into place. It's probably not anything to be concerned about, unless it just keeps moving and starts to drive you crazy. It may not be amenable to simple surgical repair -- but then again it might be. It could probably be visualized only via MRI, since it is likely essentially soft tissue.

The other possibility is that where the central line was planted a lymph node has become cystic. again, probably nothing to be overly concerned about, but it likely would be best if it could be repaired or removed.

I hope this is helpful to you.