Can normal appearing lymph nodes on ultrasound still contain lymphoma? have multiple widespread small nodes, all firm was told before scan felt concerning for low grade, gradual increasing number over last 9 months but not really growing in size?

We can not tell a Lymphoma in small lymph nodes unless the lymph nodes are growing in size. Unless the lymph node size is bigger than 1.5-2cm, I would not consider a lymphoma to be causing your palpable lymph nodes. You can monitor the size changes in your neck and seek medical advice if the lymph nodes start to increase in size to more than 2Cm.

You can 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!