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Forum Name: Lymphoma

Question: Hard lump on the back of the neck. Should I be worried?


 flying_donut - Mon Jun 07, 2010 8:51 pm

Hi Doctor,

In the past few weeks I've had some headaches. I felt some throbbing in the back of my neck and there I felt a hard lump just about .8 inches below my hairline and to the right side of the neck. When I'm feeling normal, it feels just fine and doesn't really hurt unless I push on it a little. The lump is immobile and fairly hard. I'm pretty sure I've actually had that thing for at least a year or two but I was only drawn to it recently because my doctor thinks I may have a possible sinus infection or vasomotor rhinitis and I started to wonder if that was a swollen lymph node as a result of my post nasal drip (clear phlegm) which has been going on for 7 months now with no other symptoms, though it has been fairly light and not really interfering with life. At least in the past few days which I have been watching it, I have not seen it grow or change in anyway. I'm worried it could be something serious like cancer.

I feel fairly healthy aside from this, except some days I tend to feel sleepy, tired and get headaches, but I'm quite certain this is from my sleep quality getting ruined by my congestion. Poor sleep quality is something which I have had a history of. Another thing which I think may be important is that my post nasal drip was triggered after getting a nasty flu months ago. To treat my nasal symptoms I have just begun to use nasonex which my doctor prescribed.

How worried should I be? Do you have any idea of what this might be?

-Very concerned patient
Thanks a lot doctor.
 Dr.M.Aroon kamath - Sat Jun 12, 2010 6:11 am

User avatar Hi,
It is possible that you have some form of rhinitis and post-nasal drip.But the lump you are describing, seems to be in the general location of the posterior triangle lymph nodes(level 5).

The lymphatic vessels of the nasopharynx drain in two directions, lateral and medial. The lateral drainage pathways pierce the superior constrictor muscle and drain into the lateral retropharyngeal, high Level II and high Level V lymph nodes of the neck(often bilaterally).

The lymphatic vessels of the roof and posterior wall of the nasopharynx drain medially by penetrating the visceral fascia close to the skull base and drain into the median retropharyngeal lymph nodes

The anterior part of nasal cavity drains into submental and submandibular lymph nodes and the posterior part into the retropharyngeal nodes. All of these nodes finally drain into the upper deep cervical lymph nodes.

If the swelling in question is indeed a low posterior triangle lymph node(low level 5),it is unlikely to be as a result of a nasal or nasopharyngeal pathology.

If it feels hard, you must have it examined by your doctor who will be in a better position to determine if it needs to be investigated further(FNAC-fine neede aspiration cytology).
Good luck!
 engine437 - Sat Jun 26, 2010 9:24 pm

Any help would be so great! I am feeling alone with this and I am nervous of something more severe. I am a 34 year old male with asthma. I recently was laid off and do not have medical coverage, so extensive test are not really an option. Over the last 4 or 5 weeks I have had and sore and semi hard bump on the left side of my neck kinda even with the bottom of my ear lobe about 1 to 2 inches horizontal from my lobe. People told me to try asprin which I finally did, and its helps a bit. I think my probing at the spot makes it worse. It does not seem to be getting larger in size but does feel like a knot or stiff neck. Like a pressure that is always there. It is bigger then the other (normal) right side and I can feel it when I turn my neck to the side, or down. The funny thing since I have been on asprin I seem to have more pain in my left sholder and down into the middle of my sturnum. Right below like my adams apple is. I think this possibly from the muscle relaxers aka (asprin). And my muscles are recovering from whatever. I can live with muscle aches, but this bump is scary. Does any one out there have any idea? I am going to force myself to go see my PCP soon because the icy hot and heat is no longer working. It does get better when I sleep, but when I get up it starts all over again. Thanks in advance to anyone willing to help!!!
 engine437 - Wed Jun 30, 2010 2:10 pm

Thank you Doctor, it does seem to be more hard to the touch. I think this should be checked out by my PCP. The information you talked about help my decision making process, and for that I am grateful!!
 Dr.M.Aroon kamath - Thu Jul 01, 2010 8:44 am

User avatar Hi engine437,
Your description almost pin points the location of the occipital group of lymph nodes.
Occipital nodes mainly drain the skin of the posterior scalp and neck.
Some other conditions involving the scalp, pinna and external auditory canal that may cause acute lymphadenitis involving the occipital nodes are..
- Pediculosis capitis (head lice infestation),
- bacterial infections (folliculitis, furuncles),
- tinea capitis (scalp ringworm),
- seborrheic dermatitis (dandruff),
- insect bites, and
- viral infections rubella.

Management:
- if a clear cut diagnosis is available, the condition should be treated as appropriate.
- In cases where the diagnosis of acute lymphadenitis is uncertain, a common practice is to first administer a course of antibiotics and to see the response. In cases that do not respond satisfactorily, an fine needle aspiration cytology (FNAC)
or a lymph node biopsy may be advised.

You need to consult your family physician who will be ablw to examine you and guide you better.
Best wishes!,

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