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Neck lymph node enlargement in a child

 



What to do if your child has a neck lump?

Neck lumps can be due to enlarged lymph nodes, birth cysts or lumps or (only 10%) malignancy. When you notice a neck lump in a child, consider the presentation's age. Is the child getting associated B symptoms, i.e. night sweats, fever, unexplained weight loss, fatigue, loss of appetite, trouble breathing, itching or painful swelling in their belly?

Note down any recent exposure to a person with flu-like symptoms, a young cat or any change in size or neck lumps becoming multiple. 





What happens when you visit an ENT surgeon with your child?


The ENT surgeon will take a detailed history and perform a clinical examination of the tummy, ear, nose and throat. The ENT surgeon will request special blood tests, a chest X-Ray and an Ultrasound scan of the neck. Depending on the results, it may be required to do a sample surgical biopsy of the lymph node in a few cases.


Which lymph node neck lumps in children are ENT surgeons more concerned about? 


ENT surgeons are usually concerned about neck lumps more than 2 - 2.5 cm, lumps that are firm or hard to feel, which are not sore, continuously increasing in size and associated with B symptoms as described above. These neck lumps will need a surgical biopsy.





What other neck lumps can children develop other than lymph nodes?

Other neck lumps which a child can present with are-

  • Thyroglossal duct cyst - these are the most frequently occurring type of congenital neck lumps. These neck lumps are most typically presented between the ages of 2 and 10 and present in the midline in front of the neck. It moves upon swallowing and protrusion of the tongue.
  • Branchial cleft cyst: These lumps can present in the neck anywhere below the jaw angle to the collar bone. Due to fluid collection in abnormal neck spaces, these are left open in the womb when the neck is forming.


Helping patients with specialist expertise and kindness


Mr Gaurav Kumar


Consultant Ear Nose Throat Surgeon


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