A month ago, my husband (30 years old) noticed a neck mass on the right side, just above his collar bone. It was large (approx. 4 cm), kind of squishy but firm, and moveable. He has no other symptoms at all, but he does has a family history of lymphoma, so he was concerned.
Results from an initial CT scan said a neoplasm or a necrotic lymph node was unlikely - the report suggested it could be a lymphangioma or venolymphatic malformation.
He underwent an ultrasound-guided FNA biopsy yesterday. The radiologist said that the mass ("if you can call it that") appeared quite cystic and seemed to have the density of fat, water, or air. Upon doing the biopsy, she removed about 10 ML of a straw-colored, clear fluid - essentially draining the mass entirely. For the first several hours after the biopsy, it appeared that the lump on the surface of the neck had in fact disappeared. This morning, however, the lump is back - could it have refilled itself with fluid that quickly?
We're very anxious about the results, which we hope to get at the end of the week. In the meantime, I find myself doing a lot of research about what it could be. Does the presence of fluid and the initial disappearance of the mass indicate a benign issue? What else could such a mass indicate? Should we be concerned that the lump has reappeared?
I agree with the treatment course thus far, including the FNA. It will be sent off to pathology where it can be examined for possible cancer cells.
A fluid-filled cyst is likely a benign issue, but the most definitive way to tell would be to excise the lesion and perform a more conclusive biopsy.
A referral to a surgeon can be considered to discuss this possibility.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin Pho, M.D.
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