During
your childhood or at young age, you would have noticed a protruding swelling or
solid tumour like growth that persisted for a week or two and then suddenly the
growth disappeared. You would have also noticed that along with the growth you
also suffered from cough, cold and fever. No sooner than cold and cough ended,
the swelling too disappeared. Sometimes swelling in the neck never subsides whatever
you do even after taking a full course of antibiotic and other supportive
medications. Sometimes the swelling in the neck start increasing in size
gradually. If your protruding neck swelling persist as such for months or start
increasing in size gradually, you should not ignore it and immediately consult
a doctor, otherwise your life may be at risk.
Why
does a temporary swelling form in the neck?
In a medical term, such temporary neck swellings are
called lymphadenopathy or in simple words it can be called increased size of
lymph node. These type of swellings that persist for few days in the neck are
generally caused by infection of the organs in the neck specially of teeth or
ear. Sometimes, infection of tonsil inside the neck becomes the cause of neck
swelling (enlarged lymph node). In some cases, infection in nasal sinus (
sinusitis) too causes small protuberances in neck. These type of swelling in
neck are very peculiar in the sense that they disappear as soon as infection is
eradicated. The temporary emergence of these neck swelling during infection
acts as a safety shield that prevents the infection of neck from spreading to
other parts of a human body. That’s why these lymph nodes disappear after
infection is controlled.
Be
alert, if a neck swelling neither reduces in size nor disappears
If a neck swelling has been persisting for the last
two to three weeks, you should be alarmed. This type of neck swelling or growth
generally indicates towards tubercular infection specially in our Indian
subcontinent. Tubercular infection of either lung or back bone of neck, happens
to be the most important cause of neck swelling in our country. Sometimes
salivary gland situated underneath your jaws that emits saliva during chewing
of food, if exposed to a tubercular infection will lead to emergence of small
swelling in the upper part of the neck. This problem is prevalent among
children living in rural areas where children drink raw milk without
pasteurisation or boiling. If a cattle (cow, buffalo or goat) suffers from
tubercular infection, it is immediately transmitted to children through raw
milk without having been boiled or properly treated. This tubercular infection
transmitted to children though infected milk is called in medical terms as
Bovine Tuberculosis.
If
neck swelling is increasing in size
If swelling in the neck, instead of decreasing in
size, becomes permanent or slowly start increasing in size or if there is an
increase in numbers of swellings in the neck, do not take it lightly. In
majority of the cases, it indicates the possibility of cancer of either of lung
or of wind pipe. Appearance of neck swelling means a primary cancer has been silently developing inside
the neck for a few months without any significant complaint or symptom.
Generally adults after age of fifty years suffer from cancer of lung or wind
pipe. This means if you are in your fifties and you have a permanent or slowly
growing swelling in your neck, you should promptly take doctor’s advice.
Sometimes, in ladies having breast cancer, neck swellings are also visible.
Other
reasons of neck swelling
Sometimes tumour in thyroid gland is also reason for
neck swelling. If neck swelling moves up and down on swallowing a spit, it
indicates the possibility of swelling in the thyroid. Sometimes due to previous
injury in neck, a neck swelling is visible or palpable.
Lymphoma
also an important cause of swelling in neck
In our body exists a network of lymphatic channels and
lymph nodes. In these lymphatic channels flows a liquid like substance called
lymph which is circulating through these channels which are spread throughout
the whole body. The function of lymph node is to restrict the infection and
confine it to the affected part only so that it should not spread to the other
parts of body. But in a few cases, happens a sudden and rapid structural change
in the pattern of lymphatic channels and
lymphatic nodes, a tumour like growth then appears in the neck and continue to
grow in size. This type of tumour is called in medical terms as lymphoma which
is commonly found in the neck. This lymphoma is of two types. One is called
Hodgkin’s lymphoma and another one called Non Hodgkin’s lymphoma. These
lymphomas can be placed in the category of half cancer. Sometimes, cancerous
changes do appear in theses lymphomas, it is called then as lymphatic carcinomas.
Tumour
of blood pipes in the neck
In some people there is a tumour like growth in the blood
pipes of neck. These blood pipe tumours though very small in size are present
since birth. At the time of birth, these growths are too tiny to be visible to
onlookers, but as the child progresses, the size of tumour also shows
progression. These tumours are of two types. One is called venous or
lymphovenous malformation. These venous tumours are inert, slow growing and has
no pulsations. If tumour has pulsations or if you feel the regular sound of “tick-
tick” after putting your hand on the swelling, it means the tumour is either
attached to the wall of a blood pipe carrying pure blood {artery} or the tumour
itself is originating from the wall of blood pipe. This tumour is situated in the large
sized main blood pipe called Carotid artery that carries pure blood from the
heart to the brain. This tumour in medical terms called Carotid Body Tumour.
If you ever find a pulsating protuberance or tumour in any part of the neck,
immediately consult a vascular surgeon. Never undergo for investigation
purposes any needle biopsy (FNAC) or Tru- cut biopsy, otherwise disaster may
happen.
If
you have swelling in the neck, where to go?
If you have a neck swelling, consult a vascular
surgeon. The advantage of consulting a vascular surgeon in this case is
immediate diagnosis of any vascular tumour in the neck and thus avoiding any
inadvertent attempt at needle (FNAC) or conventional biopsy as putting a needle
in such vascular tumour will lead to torrential haemorrhage and jeopardise the
life. Even if the tumour is not vascular, nevertheless he will get needle
biopsy done. All the more if a non
vascular neck tumour were to be removed or biopsied, the procedure would be safer in the hands of a
vascular surgeon because there would be lesser chance of damage to the nearby
blood pipes and will help determining the further course treatment in
consultation with other specialists after
biopsy result.
Important
Investigations required in a neck swelling
The most important investigation in neck swelling of a
non vascular origin is the needle or injection biopsy that is called in medical
terms Fine Needle Aspiration Biopsy (FNAC). In this procedure, a very tiny
piece of tumour is taken out with the help of a needle and sent for detailed
study and making diagnosis. A treatment strategy is formulated depending upon
the biopsy outcome. Some other investigations like X-ray of neck and chest, CT
and MRI are required. Sometimes Bronchoscopy is also required. In some special
circumstances, angiography may be needed. Always
remember, never allow any needle or any biopsy in a suspected neck tumour
arising from a blood pipe (Artery)
Modalities
of Treatment
If biopsy of neck swelling reveals infection of
tuberculosis, medicines to control tuberculosis are started. If along with lung
infection, there is collection of water or pus in the chest, surgery is
required. If the lung is partially or completely destroyed or there is a lung
cancer of early stage, consult a thoracic or a chest surgeon for prompt surgical
removal of diseased lung or lung tumour. Always choose a hospital where in all
modern investigatory facilities are available to help arrive a correct
diagnosis of the cause of neck swelling, because incorrect diagnosis of neck
swelling will lead to an incorrect treatment resulting into a loss of money ,time
and harm to the patient.
