Hi, Billy
Most of the time lumps and bumps are just that, but it pays to followup carefully if you are not certain of something. The FNA on my husband's swollen node did not pick up any of the cancer cells on the inner surface - only the necrotic tissue generated by his body fighting the cancer. In addition, the tumor itself was not picked up on the original CT scan. Fortunately, the ENT didn't 'like' the look of one one of my husband's tonsils, and refered him to a specialist. The primary tumor did light up the PET that our specialist ordered. The primary tumor was just barely obvious on the associated CT.

As far as blood work goes - a heightened white cell count could point to an infection that could be the cause of the swelling.

I realize that our case is not what anyone would call reassuring, and I am sorry for that, but it does point up the importance of the doctor and his/her abilities, professionalism, and familiarity with oral cancer.