LUMP IN THE NECK LUMP IN THE NECK On presentation, a careful history and examination are essential. The clinical signs of size, site, shape, consistency , fixation to skin or deep structures, pulsation, compressibility , transillumination or the presence of a bruit must be established and recorded. LUMP IN THE NECK On presentation, a careful history and examination are essential. The clinical signs of size, site, shape, consistency , fixation to skin or deep structures, pulsation, compressibility , transillumination or the presence of a bruit must be established and recorded.