A new lump or swelling in the neck needs to be assessed — most are benign (lymph nodes, thyroid goitre, lipoma), but some require prompt investigation. This guide covers the common causes, the red flags, and what scan you need.
The location of the neck lump — front, side, or back of neck — gives important diagnostic clues. Most neck lumps in Lagos are enlarged lymph nodes from infection or a thyroid abnormality.
The most common cause — lymph nodes enlarge in response to local infection (tonsillitis, dental abscess, skin infection). Usually tender, soft, and resolves as the infection clears.
Anterior (front) neck swelling that moves upward on swallowing — the thyroid. May be diffuse (goitre) or nodular. Ultrasound characterises nodules and assigns risk.
Firm, non-tender, matted lymph nodes in the neck — especially in the posterior triangle. Night sweats, weight loss. TB lymphadenitis is common in Nigeria.
Rubbery, non-tender, progressive lymph node enlargement — often multiple sites. May be associated with weight loss, night sweats, and fever. Requires biopsy.
Congenital neck cysts — smooth, soft, midline (thyroglossal) or lateral (branchial). Usually diagnosed in young adults. Benign; managed surgically.
Soft, mobile, non-tender fatty lump under the skin — anywhere in the neck. Benign; removed if troublesome.
Thyroid & Neck Ultrasound — First-line imaging for any neck lump — identifies thyroid nodules, cysts, lymph nodes, and suspicious features. Assigns TIRADS risk category for nodules.
Thyroid Function Test (TSH) — If the lump is thyroid origin — checks whether the gland is functioning normally, over, or underactive.
Full Blood Count + ESR/CRP — Identifies infection or inflammation (reactive lymphadenopathy) vs. systemic disease (lymphoma).
Chest X-Ray — If TB or lymphoma is suspected — checks for mediastinal lymphadenopathy or pulmonary TB.
Fine Needle Aspiration (FNA) — If the ultrasound shows suspicious features — a thin needle aspiration of the lump for cytology. Arranged via the clinic.
Any neck lump lasting more than 3 weeks should be assessed with a thyroid and neck ultrasound — this is the most informative initial investigation.
A lump present for less than 2 weeks after a sore throat is almost certainly a reactive lymph node. One that has been there for 6+ weeks without a clear infection cause needs investigation.
Repeated manipulation of neck lumps does not help and may cause discomfort — wait for the ultrasound assessment.
Night sweats, weight loss, other lumps, recent infections, smoking history — all of this shapes the assessment.
Walk in or book via WhatsApp — same-day assessment, transparent pricing, 4.9★ rated.