Enlarged Lymph node in the neck

I am a 40 year old male. 6 weeks ago I noticed two enlarged lymph nodes on the left side of my neck. one is exactly in the middle of the neck and another one is in the area where neck meets the shoulder. At that time I had cold and fever.

I went to my doctor he prescribed an mild antibiotic and asked me to come back in two weeks if the node doesn't disapear of shrink. After I finished my antibiotic I noticed that the Lymph node is growing bigger. Went back to my doctor, he asked to go for a blood work. The RBC count was below normal(4.16) and hemoglobin was 11.5 .  The WBC count was slightly higher that my previos bllod work which was taken three months ago durin my annual physical exam. The WBC count went up from 3.9 to 6.8 but still with in the range.

Since the lymph node was growing he asked me to go to a general Surgeon and told me that the surgeon will perform a biopsy on the node. When I went to Surgeon he asked me to go for a Ultra sound and a chest Xray. The UltraSound report come back and said that one node is 5.9cm x 1.3cm x .8 cm and another one is 2.2 x 1.0 x 1.0 cm and they appear to be cystic or necretic and suggsted to take a MRI or CT scan. I will be going for a CT Scan soon. The X ray of the Chest was didn't say anythig - everything was clear in the chest. I don't know why my General Surgeon doesn't want to perform a boipsy right away. The node is still growing. It is visible from  outside now. I am worried about Lymphoma. As of now I don't have any fever. I have slight headache. Should I insist my Surgeon to take the biopsy...

Some times when I press the nodes it is sore.  

I also noticed between the last blood work and the current blood work the Absolute Neutrophils count went up from 2300 to 5100 and the Neutrophils count went up from 60 to 73 and Lyphocytes count went down from 31 to 18.

I would appreciate any suggestion. I live in SF bay area. Should I see a Hematologist or Oncologist now.

[Dennis MD]

Hi.
You can do both biopsy and CT scan in order to know what is causing your lymph nodes to enlarge.  A good biopsy is more definitive and will tell you whether the lymph nodes are secondary to infection or to malignancy like lymphomas and carcinomas.  A CT scan, on the other hand, can give a better picture of the location as well as the extent of lymph node involvement.