Thank you all for your responses. I appreciate them. The reason I went to the second ENT was to see if there was a less invasive way to get answers, other than surgery. The first ENT simply told me that with the size of the left tonsil, the best way to know would be to remove it. We decided to just go ahead with a tonsillectomy. The first ENT never mention the lymph nodes, even though he gave me a neck exam just by touching. I was still unsure so I went to a second ENT a week later. This ENT was more focused on the lymph node(s) which came as a shock because the first ENT said nothing about the lymph nodes. The second ENT who said the nodes should come out alarmed me and I again did ask about an FNA. He told me the don't like to perform the FNA's on a node since it has been known to give a false negative or come back inconclusive. And he feels that with the tonsil and node being on the same side and both large, it is still best to take them out. Could this procedure spread cancer if it is there? I asked for blood work, imaging, anything less invasive and the ENT felt the surgery was the way to go. And yes, both spoke with me about HPV SCC so I imagine they suspect it. Thank you all again for your time. Can anyone tell me how theirs presented? What brought you in to the doctor?