Two bulges on either side of the neck should be promptly examined by color ultrasound of the neck. In some cases, it can be caused by muscle development because of the symmetry of the sternocleidomastoid muscle on both sides. In addition, the pathological state of having enlarged lymph nodes in the neck is not excluded as a result of malignant tumor if the lymph nodes are enlarged unilaterally. Bilateral lymph node enlargement can also be secondary to reactive lymph node hyperplasia, which occurs after an upper respiratory tract infection or a viral infection, and may be accompanied by fever and other symptoms. If the enlarged lymph nodes do not improve, surgical biopsy may be necessary, as some patients may have lymphoma as a cause. If confirmed by pathology, systemic intravenous chemotherapy should be systematically administered to control the progression of the tumor.