very small (2mm) tumors in the tonsils can spin off daughter cels that end up very rapidly in the nodes because the lymphoid tissue has no basement membrane to stop them, and they just move on down through the normal lymph drainage passageways. Away from these lymph passageways, lesions have to be around longer to spin off mets to the nodes, so they are bigger. I put up a long winded post a while back about this when the results of the study we did with Hopkins came in about the reason there are so many positive lymph nodes with occult oral environments. Turns out that yes the mouth was occult, but when the tonsillectomies that were performed (on normal looking tonsils bilaterally) they found 2 and 3 mm cancers deep in the tonsil - nothing to see on the surface.

Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.