Q. I am concerned about a lump on the occipital area. Please help.

Answered by
Dr. Sadaf Mustafa
and medically reviewed by iCliniq medical review team.
Published on Oct 25, 2016

Hi doctor,

About one week ago, I felt a tender lump in the occipital area of my head. It is pea sized and movable. It hurt only when I touch. It has not got any worse. In fact, it is better and less tender unless I touch it. When I had an appointment with my doctor, I was asked to give a blood sample. I got the reports back and everything was normal except the CBC. The polymorphs were 82.4 (normal range is 36 to 78) and the lymphocytes were 9.7 (normal range is 12 to 48). WBC 9.21, HCT 12.3 and HGB 36.8. I do not have any fever, night sweats, weight loss, chills or fatigue. I work out every day. I am a 50 year old mother of four teenagers. Also, I work part time. I do not have any significant medical or surgical history. My last two CBCs were normal. As I was having perimenopausal irregular bleedings, my OB drew blood. Before two years, I had similar results (high polymorphs and low lymphocytes). When it was repeated after three months, they were normal. My scalp is a bit on and off itchy, but there is no rash or open areas. I am just concerned about the blood tests along with the occipital lump.

Dr. Sadaf Mustafa

General Medicine Internal Medicine
#

Hello,

Welcome to icliniq.com.

  • The lump in your occipital region may be a small lipoma. I would suggest waiting unless it is examined by your doctor.
  • Regarding the abnormalities on your blood work, I would appreciate if you could share the absolute numbers. The percentage could be falsely elevated since your total leukocyte count is within the limit.
  • In lymphoma or leukemia, we have extremely high numbers and they do not normalize periodically. It may be reactive a bit again and I would be able to understand it better if I have absolute numbers.

For further information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

Thank you doctor,

I am not sure what you mean by the absolute numbers. I am attaching the actual results. Thank you so much for your concern and the speed of getting back to me. Would a lipoma hurt? It is much smaller and less painful today.

Dr. Sadaf Mustafa

General Medicine Internal Medicine
#

Hello,

Welcome back to icliniq.com.

Thank you for the kind compliments.

  • Absolute counts are calculated as % count x total WBC / 100. I calculated your absolute lymphocyte count and it is 893 cells per cubic mm. The normal absolute lymphocyte count is 800 to 2600 cells per cubic mm. So, your count seems to be normal.
  • Your absolute neutrophil count is 7589 x 10^-9 per liter. The normal is between 1500 and 7500. Your neutrophil count is a little high and it can be slightly elevated due to various reasons such as excessive exercise or obvious infection. Since you have no band cells, I am less convinced that this is due to an infection.
  • The lipoma can hurt if gets infected or inflamed, but it is very benign. What about yours? Can you share a picture?

Revert back with the photo to an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

Thank you doctor,

Great news about the blood results. I am less concerned now knowing that most are normal. The lump is under the scalp just above the bone of the scalp, pretty much the occipital area. It is very small now and for sure unable to see from a photo. I have a picture of a small area on my scalp from earlier this week and then again from today. The red one was from earlier and the dried looking one was from today.

Dr. Sadaf Mustafa

General Medicine Internal Medicine
#

Hello,

Welcome back to icliniq.com.

I really appreciate your kind compliments and thank you for sharing the pictures (attachment removed to protect patient identity).

  • The lesion on the scalp can cause enlargement of the lymph node and it seems like the lymph node size reduced as it has healed almost completely. It is definitely not a lipoma.

For further doubts consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

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