An adult with a neck lump

摘要

A 40 year old man presents with a 1 cm tender soft swelling in the lateral neck region. This developed seven days after the onset of a tonsillitis episode that has now resolved. He has a 20 pack-year smoking history and consumes minimal alcohol. Examination is otherwise normal. Lateral neck lumps in adults are common and may result from numerous causes (fig 1). A lump appearing in the neck after an acute infective episode is likely to be reactive; however, the main concern in these patients is to exclude an underlying malignancy. A systematic approach, as outlined below, may avoid unnecessary delay in diagnosis and treatment.