Hi Brian, Lymph node primaries can result from lymphoma which sometimes explains why there is a presentation in a cervical lymph node with no other tumor present. When excisional BX is done, then pathology reveals the type of cells present. In SCC-HN it would be squamous cells, in lymphoma, it would be lymphoma cells; other types of cancer, that specific type of cancer cell would be found in the lymph node. However, a SCC does not start in a lymph node--as live&love might be thinking. It must come from a part of the body lined with squamous epithelia. Lymph nodes are comprised of lymph tissue. I am not a medical professional, but I found out this information from doctors and from doing research on-line.