Brian,I'm sorry if I wasn't clear. They biopsied the lump and it is positive for squamous cell.
I think some of the puzzlement of the Drs is that it is only showing right there. They also thought it is unusual to be in the nodes and not show anywhere else. But, the rest of the PET shows no "uptake" as they keep referring to it anywhere else.

Dave originally had involvement in three nodes in the neck but they see no evidence of cancer after the treatment so he didn't need a neck dissection. And the BOT is also good on the PET. I think this is why it is presenting atypically.
To make it stranger, when they did the biopsy a ton of pus came out and the lump went way down. So, of course we left thinking it was an infection. He is also feeling great, gained weight, good energy,etc so we really thought infection.

They were leaning towards possible surgery and or radiation as opposed to chemo but that was just the first thought the MD was throwing out from her vacation. I do feel it's so early, there is a good chance of stopping the growth here. But I don't understand it enough to know if it means because it already jumped to there, that means it is in the system and will show somewhere else. Or is it possible, to arrest it there and have it go no further.

I'm not sure if I understand what you mean by encapsulated nodes.