ABSTRACT
The commonest acquired lump will be due to reactive lymphadenopathy. Malignancy in children is rare, but proportionally forms a higher number of certain neck lumps in children compared to the proportion in adults. Lumps that appear suddenly and last a few days would suggest infectious aetiology. Chronic lymphadenopathy with a lymph node present for longer than 3 or 4 weeks requires a different approach than the acute swelling. A lump that is progressively increasing in size would suggest a neoplasm. A lump that fluctuates or is reducing in size would be more typical of infection. Infantile haemangioma has a specific pattern of rapid growth, then involution phase, and finally involuted phase. Acute upper respiratory infections may be associated with an increase in the size of a lump, or the new appearance of a lump. The lump may discharge, suggesting infection, or be painful. The presence of pit would suggest a congenital sinus.
