Neck glands are a part of the immune system called the lymphatic system
which spreads to almost every part of the body. They are found in groups in different regions. Their number is around 200-300 on the neck.
They fight against foreign formations such as infections and cancer in the body. During this struggle
they become larger. The reason for this is the increase in the number of warrior cells (lymphocytes-antibodies) in it. In general, diameters up to 1 cm
can be considered normal. Larger ones must be followed closely.
They are grouped in the neck under the chin, in front and behind the ear, in the midline and sides of the neck, and above, in the middle and below the largest muscle in the neck. If there is an event that has the potential to harm the body anywhere in the head and neck, these glands become larger. Most cancers try to spread through the lymphatic pathways and remain stuck in the neck glands for a long time. In fact, this is also valid for other parts of the body. Usually, the lymph nodes in the area surrounding the cancer are involved. Then it spreads widely.
In a patient presenting with a mass in the neck, the age of the patient and the location of the mass are very important. While infections are generally at the forefront in children
, cancer should come to mind in those over the age of 40 and research
in this direction should be done. It should not be confused with diseases of the thyroid gland (goiter, etc.) located in the midline of the neck.
How to Differentiate?
The following feature is often present in those caused by infection.
1) Pain
/> 2) It has appeared recently
3) There is redness on the overlying skin
4) The source of infection is visible (tonsil, adenoid, sinusitis, inside the mouth, etc..)
5) On examination being soft
Possible features of cancer-related cases
1) Age of the patient (over 40)
2) Existing for weeks-months
3) No pain
/> 4) On examination, it looks like it is stuck to the skin and is hard.
5) Feeling more than one rubbery gland that looks like it is stuck to each other (may be lymphoma)
6) It is at the level of the bottom of the ear.
7) The patient does not smoke. , history of alcohol use
Non-healing wounds in ENT areas (not necessary)
In adults with systemic diseases such as diabetes, immune deficiency It should not be forgotten that the infection may spread more quickly in those receiving anti-inflammatory treatment.
A detailed examination by an ENT physician is required. If infection is predicted, drug treatment is given and closely monitored. If necessary, blood and radiological examinations are requested. If a tumor is suspected, possible sites where it may originate are examined thoroughly. Head and neck radiological examinations are requested. Biopsy
is taken from possible exit sites. A fine needle biopsy can also be performed on the top of the mass, but biopsy
should not be performed by removing a piece. Surgery or other treatment methods are applied according to the examination results. Sometimes
if sufficient information cannot be obtained from the examination and test results, the entire mass is removed and a biopsy is performed at the same time. Afterwards, antibiotics, chemotherapy and radiotherapy may be applied depending on the results. This should be decided by the following doctor or doctors.
A third possibility for swelling in the neck is the presence of congenital masses. Although these are usually noticed at a young age, they sometimes do not appear until later ages. They may swell and appear
when infected. They may cause discharge from the skin. These are masses, not lymph nodes. They are good-natured. They are usually located in the midline of the neck. Their treatment is surgery.
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