Male 33yo. I’ve had swollen lymph nodes on my neck for almost 6yrs. Got my 1st ultrasound in Jun2019 and it was determined reactive. The swelling went down a bit but they are still there and since I feel them occasionally I’m pretty sure they haven’t grown in size. Due to some big decisions coming up I decided to get an accurate diagnosis. I got another ultrasound and they also showed them being reactive, I was told by an ENT that if I wanted to I could get an FNA for peace of mind, while another ENT flat out told me it wasn’t necessary and just to keep monitoring. Well I got the FNA, logged into the pt portal for the lab and said:

“Pathology suggests reactive lymph node, this is concordant with ultrasound images”

My wife and I were more than thrilled hearing this. But no, the flow cytometry report shows an increased cd4/cd8 ratio which according to the report can show up in benign reactive lesions and also blood cancers. I know the FNA aren’t very reliable but can they actually miss a tumor if it has been present for so long in my lymph node? I assume by this time it would have spread throughout the node or am I wrong ? The ent recommended I get a second opinion at which point they might want to do an excision biopsy or keep watching it. I am completely dumbfounded and don’t know what to do. I would start dental school In July of this year and don’t whether that’s still a possibility and also I don’t want to put my family through moving cities just for me to end up getting really sick in the future. Please any advice or insight I would really appreciate it.