Hi, Swollen glands are not unusual and can be caused by a variety of different conditions. Most often we see this occurring in simple viral upper respiratory infection or sometimes strep throat. In these cases, the ESR is also likely to be increased as well. The ESR is not a very specific test and can be elevated by many many things. If your physician did lab work, which it sounds like they did, then I am sure they also would have obtained a complete blood count. The physician is concerned about possible lymphoma, which is why they are ordering the FNA, however lymphoma would have should some abnormalities on the CBC, usually an elevated lymphocyte count. I really do feel your physician is just being cautious. You would rather have him be proactive and thoroughly research for all possible causes of this rather than just dismiss it. I think is is very unlikely the FNA will show anything abnormal at all. I know it is scary but your doctor is just being thorough. Try to rest easy. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. David Girardi, Internal Medicine Specialist