Hi XXXXXXX

Thanks for your query,

The possible diagnosis of lumps in the area specified with size varying from 0.5 cm to 3cm or more could be as follows :

1) Lymph node : usually they do present with pain if they are pathological.they can appear in the neck when there is infection in the structures in vicinity like face ( acne) , oral cavity infections, lesions in the skin over the neck etc or when there is actual infection in the lymph node itself like TB, or malignancies( multiple nodes ).They are firm to touch and there would be no effect on contracting the muscles in that area.

2)Neurofibroma : is a benign nerve sheath tumor in the peripheral nervous system.Very common lesions present without any symptoms and not serious. They need no treatment unless there are symptoms due to nerve compression which is rarely encountered.They are firm to touch.They become prominent on contracting the muscles in that area.

3)Lipoma :is a benign tumor composed of adipose tissue. It is the most common form of soft tissue tumor. Lipomas are soft to the touch, usually movable, and are generally painless.They become prominent on contracting the muscles in that area.

The above are some possible and common causes for a painless lump around the neck and well diagnosed by a ultrasound.

The prognosis of the lesion if lymph node mass depends on the underlying cause ,the other two possibilities mentioned above are not serious and need no treatment.

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Hi again,

Yes, as i mentioned in my first differential diagnosis , the chances of malignancy like Hodgkin's has to be ruled out.

Hodgkin's at the time of diagnosis could have involved atleast more than 2 groups of lymph nodes( groups like neck , arm pit, inguinal, abdominal, para aortic etc).More commonly affecting the neck and the inguinal lymph nodes and the involved lymph nodes being more than 2 cm in size and multiple in number.
You have to be examined for the above criteria to consider Hodgkin's as possible diagnosis.

Wish you good health.

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