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Lumps on neck, cyst, ultrasound and blood test done

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Answered by

ENT Specialist
Practicing since : 2001
Answered : 2291 Questions
highly vascular rounded mass...
Hi Dr,

I went to the doctors as there was a noticeable lump under my neck (to the left) - been there for about 6 weeks now and got bigger. He claimed it was a cyst that needed to be removed. I went for an ultrasound and they were able to completely rule out a cyst and in actual fact ended up discovering an enlarged lymph node.

ultrasound results (below):

There is a well circumscribed highly vascular rounded mass just to the left of midline within the sublingual area measuring 11 x 8mm.

Both SMG appear normal.

At the base of the left neck at the anterior chain is an enlarged lymph node measuring 27 x 12mm which is highly vascular.

No other unusual masses seen within the neck or supra clavicular fossa.

In light of these findings Malignancy must be considered.


Suggest urgent follow up imaging such as MRI to assess extent and nature of mass and Lymph nodes.


The blood test results have come back with the below comments:

Reactive lymphocytes seen suggest check virology. If symptoms persists consider lymphonode biopsy''

I have an ENT appointment Friday 6th XXXXXXX 2012 at 10:15am.

Please can you let me know what you think? I now have pain over the left side of neck too...

Thanks in advance
Posted Tue, 8 May 2012 in Skin Hair and Nails
Answered by Dr. Naveen Kumar 5 hours later

Thanks for posting your query.

According to the ultrasound report given by your doctor, the enlarged lymph node could be as a result of local lymphadenitis or lymphomas or nasopharyngeal carcinoma.

In your ultrasound report, it has been mentioned that it could be enlarged secondary to the malignancy in the head & neck region. The commonest malignancies to be thought of are either nasopharyngeal carcinoma or Lymphomas. As the blood counts are low, Lymphoma is ruled out. There is no history of fever, pain or tenderness over the swelling, hence lymphadenitis is also ruled out.

To confirm whether it is related to the nasopharyngeal carcinoma, you need to get a nasal endoscopy and a magnetic resonance imaging (MRI) of the brain done. Alternatively, an excision biopsy of the lymph node in the neck can throw some light regarding the histological status of this condition.

Hence, I would suggest you to consult an apt ENT specialist and get a thorough check-up done.

Hope I have answered your query; I will be available for the follow-up queries.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
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