OpenHealth Q&A

Concerns Over Neck Lump, Weight Gain, and Blood Test Results in a Toddler

I've been uneasy about a lump on my son's neck since he was just 7 months old. Initially, I would only see it briefly when his head tilted back during moments of distress, which made it difficult to assess due to the presence of baby fat. Now that he’s a toddler, the lump is visible whenever he looks up, such as when gazing at the ceiling. It's very soft to the touch, almost indistinguishable, and has remained proportional to his growth, currently resembling the size of a small grape. At birth, he was in the 50th percentile for weight, but by the time he reached his first birthday, he had dropped to the 25th percentile. Now, at 27 months old, he is at the 5th percentile. Despite this, he remains an energetic and cheerful child, meeting all developmental benchmarks, with his height and head circumference tracking consistently. His diet includes a broad range of foods. Given these developments, our pediatrician recommended a complete blood count (CBC) and is now referring him to a pediatric surgeon for further imaging and evaluation. The CBC results indicated some areas of concern. The pediatrician pointed out that the findings could suggest a recent infection, yet my son has been healthy with no sickness for the past five months and continues to be his usual lively and happy self. The most concerning results include elevated lymphocytes and decreased neutrophils. Naturally, I am feeling anxious about the possibility of cancer, particularly since my brother was diagnosed with T-cell lymphoma at 26. While I know that further time and testing are necessary for a definitive diagnosis, I would appreciate any insights regarding the CBC results. Do they appear worrisome given that he is asymptomatic, or are they merely slightly off normal? I'm uncertain about which results might raise red flags for cancer. I understand that cancerous lumps are typically firm and immovable, so could a soft lump like the one I described also indicate cancer? What other explanations could exist for this lump if it has been present for so long? Here are the CBC values for reference: - WBC: 7.53 (normal) - RBC: 5.12 (high) - Hemoglobin (HGB): 13.3 (high) - Hematocrit (HCT): 39.5 (high) - MCV: 77.1 (normal) - MCH: 26 (normal) - MCHC: 33.7 (normal) - Platelet Count: 348 (normal) - RDW: 13 (normal) - MPV: 8.9 (low) - Neutrophils: 25.6 (low) - Lymphocytes: 65.3 (high) - Monocytes: 6.9 (normal) - Eosinophils: 1.3 (normal) - Basophils: 0.8 (normal) - Immature Granulocyte: 0.1 (normal) - Absolute Neutrophils: 1.92 (low) - Absolute Lymphocytes: 4.92 (high) - Absolute Monocytes: 0.52 (normal) - Absolute Eosinophils: 0.1 (normal) - Absolute Basophils: 0.06 (normal) - Absolute Immature Granulocyte: 0.01 (normal)

Answers (1)

9/10/2025, 8:31:08 PM

OpenHealth AI

It's understandable to feel anxious about your son's health, especially with the lump on his neck and the recent CBC results. Based on the information you've provided, the lump being soft and having been present for a long time does not immediately suggest cancer, especially since he is otherwise healthy and meeting developmental milestones. Let's break this down further.

Key Points

1. Lump on the Neck: A soft, movable lump in a toddler can often be benign, especially if it has been present for an extended time without significant change. Common causes include lymphadenopathy (swollen lymph nodes), which can occur after infections, and other non-cancerous conditions.
2. CBC Results:
   • The complete blood count shows elevated lymphocytes and decreased neutrophils, which could indicate a recent infection or a reactive process rather than cancer, particularly as your son remains asymptomatic.
   • While the results should be evaluated in context with his clinical picture, by themselves, they do not immediately signal cancer.

Explanation of CBC Findings

• Lymphocytes: Elevated lymphocyte counts can often be seen in viral infections or other conditions that cause the immune system to respond.
• Neutrophils: A decrease can be a transient finding and often reflects a prior infection. It's important to monitor these changes with repeat tests.
• A normal white blood cell count further supports that there's no severe systemic issue currently.

Next Steps

1. Continue Monitoring: Keep an eye on the lump for any changes in size, firmness, or signs of tenderness, and take note of any new symptoms (e.g., fever, night sweats).
2. Follow Up: Attend the appointment with the pediatric surgeon for imaging and further evaluation as recommended. This can help clarify the nature of the lump.
3. Diet and Growth: Maintain a balanced diet and ensure your son is getting enough nutrients. Since he was at the 5th percentile for weight, consider discussing nutritional support or guidance with your pediatrician if concerns persist.
4. Stay Informed but Calm: It’s natural to have concerns given your family history, but stay focused on the facts. Most lumps in children, especially those that are soft and moveable, are not cancerous.

Lastly, don’t hesitate to bring up your fears and questions with your pediatrician and the surgeon; they can provide reassurance and clarity regarding the next steps in your son's care. The most important aspect right now is to keep him happy and healthy while you navigate these evaluations.