lymph normally react to

1. infections
2. dirt
3. cancer

they may also enlarge because of abnormalities

1. benign
   1. sarcoid
   2. sinus histiocysis
2. malignant
   1. contain cancer that has spread
   2. tuberculosis
   3. lymphoma
      1. cells multiply and fail to mature properly
         1. dozens fo types
            1. go away
            2. life threatening

Pet CT

1. lymph nodes that are larger than normal
   1. over 1 cm diameter
      1. 1-2 cm borderline
2. lymph nodes that take up more glucose than normal
   1. Warburg effect
      1. correlates with malignancy
      2. node is unsually active

enlarged nodes that are deep inside are not easily accesible

therefore: surgeon

laporoscopy

tube inserted into the abdomen to get the biopsy

SUV: standard uptake value: relative amount of suugar in the hot nodes

very hot nodes have SUV 10 or more