TGF,
one last input: I just returned from a bi- monthly check-up with my surgeon, and here is what he told me about regarding the enlarged lymph node (painless) I had in my neck for about 2 weeks before it vanished. I did not have a cold, and never had a visibly enlarged one before

Thanks, Sigrid. I have an appointment lined up for Tuesday, April 22nd with my ENT for the recheck on the node in my neck. I told his nurse Friday that I had also noticed a small hard lump in the roof of my mouth and did not know if it was anything to be concerned about. She said she would make a note of it in my file and then she scheduled me to come in Tuesday, 4/22. Hopefully, I will get some answers on that date. I'll keep you all posted, and once again, thanks for the advice and concern. TGF

Just a quick update. I saw my ENT yesterday afternoon who related that the hard lump in the roof of my mouth appeared to be as Brian said, "a torus", which is common. He rechecked the lymph node in my neck/cervical area and related that he really thought it would have gone away on its own by now. He stated that we could continue to watch it or he could remove it. I asked about the fine needle aspiration, but he stated that he felt sure from the ultrasound and CT scan that it was a lymph node and stated that he expected the fine needle aspiration to reveal lymphocites(?)which would cause the pathologist, in turn, to ask for a tissue biopsy. So, he suggested doing one procedure instead to remove the entire node. He said it would involve about a 2" incision in my neck under general anesthesia but would be faily simple. I am scheduled for my pre-op visit on Monday and surgery on Friday of next week. It just seems radical for such a small lump. The doc stated that my options were either to continue to check it about every two months or get rid of it and make sure everything is alright. He said he was 90% sure it would be benign, but it was best to be safe. I am anxious to find out just what the surgery will entail. I hope I've made the right choice. Thanks for your e-mails. TGF

A fine needle biopsy IS a biopsy, and yes since it is of a lymph node (which is obvious) it will contain lymph tissues(cells, ie. LYMPHOCYTES, and fluid). The question for the pathologist who reads the cells from the needle aspiration is...are any of them malignant or do they have abnormal nuclei. You are undergoing a general anesthesia procedure for something that can be determined from a simple needle aspiration. For sure you should not wait and see...that just isn't a good idea, but excising the node under a general may not be necessary either. IF they find some malignant cells (hopefully not)...then the question for the doctor is where is the primary? Excising the node isn't going to give him any more information than the FNB if they find abnormal cells.

Brian,
Our Fine Needle Biopsy experience was a little different. They originally thought my husband's neck mass was a brachiocyst, but did a CT Scan and Fine Needle to confirm. The fine needle biopsy came back as negative for malignancy and the CT scan looked benign, too. The doctor told him not to worry but that he should probably have the mass removed at some point. It wasn't until I got on the internet and started reading some information that we decided to get things moving more quickly. They got him in and removed the mass and it was the frozen section that showed cancer cells (at which point they also confirmed that it wasn't a brachicyst, but a lymph node).

Anita

Is there an exception to every test...yes. For sure a fine needle biopsy is highly dependent on the operator collecting enough material to include malignant cells. This may involve several punctures within the node, and even then, as in your case, it may not hit a hot spot. My point is simply that patients should try the least invasive procedure which will give them the quickest results (in 24 hours in this case). If that node is a malignant metastasis, and the FNB finds it, you have eliminated a general anesthesia procedure, and know this week if something is there. Ceretainly taking out the whole node will guarantee that you won't miss those malignant cells. FNB's are not infallable, but then neither is an mri, pet scan, CT etc. Everyone of these is dependent on someone reading it correctly, the contrast medium lighting it up, etc. etc. FNB's have provven themsleves to be a valuable tool for many years. They take 5 min, they are inexpensive, and if done correctly, (collecting enough material) they can be highly accurate. 100%? No. I am always wary of anyone who wants to cut first.......unless they have significant suspicions from other symptoms that are fingers pointing at a potential diagnosis.

Also to Sigrid (since you are probably following this thread): I have tried to respond to your private message or send you an email in relationship to your question. You have the prevent private message and email buttons selected in your profile and I can not write to you.

Hi TGF, I'm glad you are getting this thing resolved.

For what it is worth my ENT wanted to set up a surgical removal of my lump regardless of how the needle biopsy came out. The only difference was how fast it would be scheduled. (it was about 1 cm in size)

The best way to be really sure what it is would be the complete removal and then the pathologist can look at everything.

I guess my ENT felt that the full removal would give him the best results. He stated that sometimes he uses a local anesthesia and sometimes he uses general anesthesia depending on his evaluation. He stated that he would probably use a general anesthesia since he's not sure how much it may have changed in the past five months. I can't tell that it has changed much, maybe just a little more elongated. When I go for my pre-op appt on Monday afternoon, he stated they would go over everything with me and let me know his final evaluation and recommendation. He stated that they would do a lot of blood tests also at that time, and my surgery is scheduled for Friday at the hospital ambulatory surgical section. What is generally involved in an excision of a small lymph node? A 2" incision doesn't sound too radical, but then I don't know what others have had. I'm mostly concerned about muscle tissue and nerves in that area, and I plan to speak to him at length on Monday about this. Any suggestions? Thanks, TGF

TGF, The type of incision that he is talking about should not create many problems with nerves nor any other major structures.

To put it into perspective the "radical neck dissection" you see mentioned here in various posts creates an incision from behind the ear to the tip of the chin and then from about the middle of that to the collar bone. The long term dificulties with radical neck are related to a nerve that parallels a string of lymph nodes and is sometimes removed causing the Trapezius muscle to stop functioning, (this can result in shoulder problems) and a muscle called the Sternocleidomastoid (who comes up with these names!) which is also removed to gain access to the deeper regions of the neck. The surgery usually gets you 3 to 6 days of hospital stay.

The incision to remove one node or lump is NOT what I described above. In other words, if that is all you need done it will likely be a walk in the park for you. No effects on eating, swallowing, taste, etc. and a quick recovery (Walk out same day).

I will Pray that you come home with a smile.

Thanks, Mark. The procedure you described to remove the one small node sounds like the type procedure the ENT plans to do. He stated that I would have it done in the morning and go home that afternoon. He stated that a follow-up appt would be made for the following Thursday to take out the stitches and go over the results of the pathology report. I'll keep you updated, and, again, I want to thank all of you for your input. I'm sure everything will come out good. The ENT said he was 90% sure it would be benign, so that's what I'm banking on. My faith is strong. This site has been more helpful to me than any of the research I have done myself. Thanks, again. TGF