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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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24 Year Old With A Painful Lump Near The Collar Bone. Treated For Melanoma Cancer. Family History Of Lymphoma. Any Suggestions?

Hi I am 24 years old and a week ago i found a lump on the left side of neck near my collar bone. A few days ago it started to hurt and now it hurts when I try to turn my head or lay down at night. I havent been sick in almost 6-8 months. I have felt more tired in the past month but I cant sleep at night. I have been told about 3 years ago that i had Mellonomia skin cancer and I had it removed. I also have a family member that has survived Lymphoma and its worrying me can you tell me what I need to do. Oh and another thing I do not have health insurance at the moment. HELP!
Sat, 24 Nov 2012
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM
The neck region (near the collar bone) has a large number of lymph nodes.
Any swelling in this region can be a lymph node enlargements.
Malignancy of lymph node ie lymphoma is not usually painful but involvement of nerve can cause pain.
Since you have afamily history of lymphoma, it has to be ruled out by some investigations.
A FNAC (Fine needle aspiration cytology) needs to be done. In this procedure cells are sampled with a needle and are seen under the microscope.
If malignant cells are present firther excision is done and histopathological examination is done. Histopathological examination characterises the type of lesion.

Since you have a history of melanoma in the past, melanoma can reccur as it is an aggresive tumor and can metastasize to lymph node.
FNAC will give information about the type of cells in the lymph node.

The pain associated with the enlargged lymph nodes indicates some kind of inflammation.
Infection in the head and neck region often cause enlargement and pain in the local lymph nodes in the region.

Consult your doctor for investigation.
Next step/ investigation will be decided subsequently.

Thanks and take care
Dr Shailja P Wahal

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General & Family Physician Dr. Das Arindam's  Response
Hello, welcome to HCM,
Your history suggests this lump to be a supraclavicular lymph node.
Now, it has to be examined clinically examined for its size, shape, consistency,mobility before commenting anything.
This type of palpable lymph node may be found due to many causes like infections, lymphoma, metastasis. From clinical examination, it is difficult to comment. For this, you have to go for Fine needle aspiration cytology from this lymph node.
If FNAC becomes noncontributory, excision biopsy should be done for appropriate diagnosis.
Regards.
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24 Year Old With A Painful Lump Near The Collar Bone. Treated For Melanoma Cancer. Family History Of Lymphoma. Any Suggestions?

Hello and welcome to HCM The neck region (near the collar bone) has a large number of lymph nodes. Any swelling in this region can be a lymph node enlargements. Malignancy of lymph node ie lymphoma is not usually painful but involvement of nerve can cause pain. Since you have afamily history of lymphoma, it has to be ruled out by some investigations. A FNAC (Fine needle aspiration cytology) needs to be done. In this procedure cells are sampled with a needle and are seen under the microscope. If malignant cells are present firther excision is done and histopathological examination is done. Histopathological examination characterises the type of lesion. Since you have a history of melanoma in the past, melanoma can reccur as it is an aggresive tumor and can metastasize to lymph node. FNAC will give information about the type of cells in the lymph node. The pain associated with the enlargged lymph nodes indicates some kind of inflammation. Infection in the head and neck region often cause enlargement and pain in the local lymph nodes in the region. Consult your doctor for investigation. Next step/ investigation will be decided subsequently. Thanks and take care Dr Shailja P Wahal