Ciao- so I am a bit worried- I'm 36 female

Patient

Q: Ciao- so I am a bit worried- I'm 36 female and have smoked a pack a day for 20 years. In the past two years I've developed neck and should pain and lots of cracking sounds- also a lump that runs diagonal from the right side of lower neck to shoulder- it gets bigger and smaller. I had an ultrasound of it and it came back normal... Now I'm reading shoulder pain is symptom of lung cancer and my anxiety is through the roof. Could the ultrasound have missed something?

Doctor

A:   Hi,

Thanks for your query.

Read the history and understood your concerns.
Your reading shoulder pain is a symptom of lung cancer caused you severe anxiety and wants to know whether the ultrasound have missed something.

Since you have neck pain as well as lots of crackling sound in neck indicates otherwise. It may be due to cervical spine problem, Another cause of shoulder pain could have been local shoulder pain due to inflammation of the joint itself or the capsule around it, causing restricted movements.

Another reason can be gall bladder disease- it gives pain as a referred pain.

If the lump on the right side of the neck would have been due to a lymph node that gets bigger and smaller, ultrasound should not have missed it.

The cancer of the lungs can be confirmed or ruled out the best by a contrast enhanced CT scan of the chest and the neck. To be confirmed by FNAC that is fine needle aspiration cytology. Hence I would advise you to get this done as you have history of being 34 and smoking a pack a day for the last 20 years.

I hope this answer helps you, alleviating the fear you are unnecessarily developing.
Please feel free to ask for further relevant queries if you feel that there is a gap of communication.

Comments / Follow Ups

Patient: Thank you so much for getting back to me so fast!!! I did have a CT scan on my neck area and top of lungs two years ago and it was fine- and I do have acid reflux and under tremendous stress/ anxiety family emergency last few weeks.. I am just scared this lump is a tumor on upper lung or there's one underneath it making the muscle rise... I guess if you wouldn't mind clarifying that the ultrasound I had a few months ago would've missed it- def not a lymph node... thanks a million :))))) B
Best Danielle
Doctor: I can understand when one goes through the stress/anxiety, causes muscles spasms with secondary effects.
CT scan of 2 years ago was fine, but 2 years is a long time ago and can have lots of changes in 2 years.
Ultrasound is done by a man and infers what is seen on the screen- It has lots of limitations like the waves can not pass through bone as there is clavicle at the base.
And the best part is this is repeatable, hence go for a review Ultrasound or still better the CT scan to get the proper diagnosis by confirming or ruling out certain things.
Get proper treatment for anxiety if needed and for the acid reflux as it disturbs a lot.
Small troubles combine together to cause more symptoms than the real disease.

I hope this answer helps you.

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