swollen lymph nodes

Quick question.....do all persistenly swollen lymph nodes need to be biopsied? In the case of myself, a 26 year old male in good health, non smoker etc. with NO B SYMPTOMS.....would you suggest a biopsy? There are 4 nodes in the submandibular region, left sided (suprclavicular LN negative), non-tender, mobile, firm.  They've been there for over a year now.  I feel fine, but no the significance of persistenly swollen LN.  Would you suggest a biopsy?

Also, HIV negative.

[help3]

get on the net and get on sites that have throat cancer and tumors and compare. read up on it and reguardless  always go with your gut instinct on this.you know your body better than anyone

[nonce]

I know that its not throat Ca....this would be very unlikely in my age group.  Further, I do not smoke.  Therefore, laryngeal (throat) Ca is unlikely.

Lymphoma is the only thing that comes to mind.  Localized Ca in that region would be unlikely, metastatic Ca from another region would be even more unlikely.....but lymphoma could entirely possible.....i dont know enough about it.

[OtoHNS_MD]

That's hard to say... a year is a long time for lymph nodes to be enlarged for an adult.  A fine needle biopsy could be simple 1st step, although it is not as good at diagnosing lymphoma.  I agree that head and neck cancer associated with smoking (usually squamous cell carcinoma) would be unlikely in your age group, but (rarely) I have seen it...even in non smokers.  I would see an Otolaryngologist for an eval.  Overall, the chances are low that you have anything worrisome.

[Enoch Choi, MD]

OtoHNS_MD has good advice.  it can happen.  See an ENT and they can check it out.  I usually reccomend lymph nodes that don't shrink after a month to get checked out.