Should a level il lymph node measures 1.9 x 0.9 cm with irregular morphology be removed surgically before doing a biopsy first? lab work was normal?

Surgical resection of level II lymph node gives you a better sample for pathology than a biopsy and technically the procedure for 2 approaches is not much different.

Agree with Dr. Le. An alternative to removing the node is to watch and wait. You may feel the nodes every couple of weeks, if any of the lymph glands doubles in size, becomes painful, ulcerates, or other nodes become enlarged, or you develop fever, or lose weight, you should see a doctor. Wish you good health!