Do blood tests and a chest x-ray rule out lymphoma? I have had two blood tests and chest x-rays, both of which were normal. As I read in internet, the only way to know whether a swollen lymph node harbors lymphoma is to have it biopsied. My PCP said my lymph node is same size (not changing size for 3 months, 1- 1.5 cm) so nothing to worry about. My general surgeon is ready to biopsy, just to be sure. Just needing an opinion.

The vast majority of lymph nodes in HIV'ers are indeed nothing more than the body's attempt to fend off the HIV virus. However, lymph nodes can certainly harbor infections and cancers (in particular lymphoma and Hodgkin's disease). A lymph node is more worrisome if it is out of proportion to all the other lymph nodes, if it occurs in the setting of systemic symptoms (fever, chills, night sweats, weight loss), or if it occurs in folks with particularly low CD4 counts (e.g. if CD4 <50). There is no magic size below which guarantees that you have nothing to worry about, or above which guarantees that the lymph nodes is harboring something. That said, many physicians use a 2 cm cutoff; lymph nodes larger than 2 cms are more worrisome than lymph nodes smaller than 2 cms.

In your case, a lymph node 1 -1.5 cm which has not changed over 3 months may indeed be and probably is nothing to worry about. That said, I would recommend you getting it biopsied if, as above, you have systemic symptoms or a particularly low CD4 count, if this lymph node is out of proportion to the other nodes, or if you are losing sleep over it. As we say, "when in doubt, take it out". Once it's out, you'll have one less thing to worry about.

Normal blood tests and normal chest x-ray do not guarantee that you don't have lymphoma. BD.