The appearance of a lump in the neck for no reason is undoubtedly a disturbing thing, where does the lump come from? Is it an inflammatory disease or a malignant tumor? How can the diagnosis be confirmed? These are the questions that patients are most concerned and confused about. To answer these questions, first of all, we have to popularize: the neck is the place where lymph nodes gather, these lymph nodes are around the large blood vessels and nerves in the neck, and deep in the muscle tissue, they are an important part of the huge immune system of the human body, not only will there be reactive hyperplasia and enlargement when local inflammation occurs in the human body, but also the transit point for many head and neck tumors to metastasize, many head and neck tumor patients often do not have any subjective symptoms. Many head and neck tumor patients often do not have any subjective symptoms, but the first thing they find is the enlargement of lymph nodes in the neck, so that some patients are afraid of talking about “nodes” and pay great attention to and worry about neck masses. Inflammatory reaction: This is the most common cause of swollen lymph nodes in the neck. As mentioned above, lymph nodes are an important part of the lymphatic system and an important gateway to the body’s immune response. Whenever foreign enemies come, lymphocytes in the lymph nodes, like warriors defending the city, rise up to defend our body from external insults and protect it from bacteria and viruses, and their response is very timely and violent. Especially in children and adolescents who are underage, because their immune function is more advanced compared to adults, the reaction is often more intense, and the swelling of lymph nodes in the neck is very obvious, even forming bead-like enlargement, which can be easily seen or felt even by people who are not medically trained, so that it often causes unwarranted panic. In fact, this is the normal immune response of the human body, when there is a systemic or local infection, for the swollen lymph nodes in the neck, rather than general anti-infection treatment, while carefully observed, they will generally gradually shrink or disappear with the control of inflammation, it is not necessary to worry too much. Tuberculosis: Tuberculosis is a common respiratory infection caused by Mycobacterium tuberculosis. Most patients have the common knowledge that patients suffering from tuberculosis will have symptoms such as coughing, sputum production, weight loss, facial flushing, low fever in the afternoon, night sweats, etc. If left untreated, they will eventually bleed and die of exhaustion. However, few people know that lymph nodes can also be infected with tuberculosis. The invading mycobacterium can enter and stay in the lymph nodes with the lymphatic fluid, and the patient will not have all the respiratory symptoms that tuberculosis patients have, but will only have enlarged lymph nodes in the neck. Some infected lymph nodes may gradually fuse to form a large mass in the neck, or even break down and flow pus, forming a prolonged sinus tract or a local abscess, which is more common in young people. Medical professionals often jokingly say that mycobacterium tuberculosis can change its face and lurk to harm people! Therefore, if you have swollen lymph nodes in the neck for no apparent reason and have a history of tuberculosis or exposure, go to the hospital promptly and undergo a lymph node biopsy. There is no need to panic after the diagnosis of tuberculosis. Since huge lymph nodes in the neck, especially necrotic and liquefied masses in the central part after fusion, are difficult to be completely eliminated by medication, the doctor can clean the lesions by surgical operation with anti-TB medication, which is very effective, and there have been many successful cases in this regard, and patients have recovered rapidly. Malignant lymphoma or metastatic cancer: Malignant lymphoma is a malignant tumor of the lymphatic system, and a neck mass is often its first manifestation, and a few patients will have systemic symptoms such as low fever, weakness, and emaciation. When patients come to the clinic, the neck mass is usually already very obvious, and the fused lymph nodes form one or several huge masses with hard texture, unclear boundary and poor mobility in the neck, with no abnormal surface skin and usually no obvious pressure pain (e.g. Figure 2). The doctor will generally have a preliminary judgment based on the performance of the mass, but there is only one way to finally confirm the diagnosis, and that is —- biopsy! Biopsy, in short, is biopsy, through fine needle aspiration or surgical excision, to obtain the lesion tissue and send it to pathological section for examination, then we can draw a conclusion and determine what the lesion really is. As for metastatic cancer, any malignant tumor in the head and neck may have metastatic lymph nodes in the neck and lead to the appearance of neck masses. The presentation of neck masses is similar to that of lymphoma in that they are large, rigid, fixed masses with unclear borders, and the doctor can easily make a judgment and will actively search for the primary lesion. Confirmation of diagnosis requires biopsy in the same manner as malignant lymphoma. Needle aspiration biopsy is relatively less invasive, but has a limited detection rate due to the small amount of tissue obtained and poor histomorphology. Surgical biopsy is relatively more invasive, but has a well-deserved confirmation rate and allows for simultaneous elimination of the lesion and surgical reduction of the tumor. All you need to do is to actively cooperate with the doctor to identify the cause as soon as possible, treat it in time and win back your health! Thyroid tumor: The thyroid mass is usually superficially located, in front of the neck or on the front side, which is easier to be found, while in men, it is easy to be ignored because of the prominent laryngeal nodes. Regarding thyroid masses, as we have described in the topic, here, briefly, they can be divided into benign and malignant. Benign thyroid masses are commonly seen as nodular goiter and thyroid adenoma. Here it is important to remind you that there is another congenital malformation, called nail and tongue cyst, located on the anterior midline of the neck near the hyoid bone. This kind of thing usually does not cause obvious subjective symptoms and patients often discover it unintentionally, and because of the insidious occurrence and development, although it is a congenital malformation, there are many patients who discover it only after adulthood or even in middle and old age. This disease can cause repeated local infections, and the abscess can penetrate the skin and form a persistent fistula in the front of the neck, which repeatedly flows pus, and if not removed cleanly, the recurrence rate is extremely high. The most malignant tumor of the thyroid is thyroid cancer, but there are also other types such as malignant lymphoma and sarcoma. Undoubtedly, since they are malignant tumors, early detection and treatment is a must, otherwise once the tumor spreads or metastasizes, the consequences are unthinkable. Compared with other tumors in the head and neck, thyroid cancer is a relatively less malignant cancer, and surgery is the best and preferred treatment method for this cancer. Therefore, please don’t think that cancer is incurable and there is no need to make any effort, this is a wrong and irrational idea. In conclusion, for the sake of your physical and mental health, to improve the success rate of surgery and to avoid confusion caused by unnecessary damage, you must actively cooperate with your doctor when you find a neck lump, improve the examination and have early surgery if necessary!