If there is painless, progressive enlargement of the cervical lymph nodes, and the lymph nodes are firm in texture, movable without tenderness, and accompanied by enlargement of other superficial lymph nodes, it may be caused by lymphoma. A lymph node biopsy is necessary for diagnosis.If there is a single enlarged lymph node in the neck, which is hard in texture, less movable, and without tenderness, it is likely due to tumor metastasis, such as from lung cancer, esophageal cancer, or gastric cancer. In cases of cervical lymph node metastasis, a needle aspiration biopsy is usually performed to confirm the diagnosis.If the cervical lymph nodes are tender, more movable, and softer in texture, it is generally considered to be caused by inflammation.