56 y/o male has blue pale tongue and painless posterior cervical lymphadenopathy. no fevers, he doesn't know how long this has been the case, ?

Needs evaluation now: If the tongue is a pale blue color, you're probably seeing some sign of anemia. When I think of anemia and enlarged lymph nodes, I think of performing a biopsy of those lymph nodes. This must have evaluation by a doctor - because of the implications of what this could be. It may well have gone on for months, but we need to know what this is now, and therefore get on the right path to treatment.