The possibility of a primary cancer located in the neck can be difficult and overwhelming. Further testing will be necessary to confirm a diagnosis and determine the best course of treatment. Imaging and biopsy are the standard diagnostic approach. Patients can expect their doctor to discuss the risks, benefits, and alternatives to each of the following:
Imaging
Imaging scans, also known as radiologic studies, provide the doctor with an inside view of the body. Imaging of the head and neck will be required to determine the extent as well as the behavior of a growth, and is a vital step prior to treatment of any tumor in the neck. The most common initial imaging tests used are CT and MRI scans. A more advanced imaging study called a PET/CT may also be helpful in determining whether lymph nodes in the neck are likely to harbor cancer cells. Learn more about imaging.
Serology
Serology involves checking the blood for certain proteins, including viral proteins, antibodies to certain bacteria, and markers for inflammation. Doctors may also test for tuberculosis by injecting an antigen just under the skin of the forearm. If a patient is diagnosed with lymphoma, doctors will perform a host of additional lab tests and possibly biopsies. Learn more about serology.
Biopsy
A biopsy is the removal of a small piece of tissue to examine under a microscope to see if it is cancerous. A biopsy of a suspicious lump in the neck is usually needed prior to treatment. In the majority of cases, a fine needle aspiration (FNA) biopsy will be performed to sample any suspicious growths in the neck. The doctor performing the biopsy may use ultrasound or CT scan to guide the procedure. Sometimes an FNA biopsy is unable to make a diagnosis, and core needle biopsy or an open (incisional or excisional) biopsy will be necessary to make a final diagnosis and begin treatment. Learn more about FNA and other kinds of biopsies.
