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Lymph Node Biopsy
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Lymph Node Biopsy

(Biopsy Lymph Nodes)

En Español (Spanish Version)

Definition

A lymph node biopsy is the removal and examination of all, or part, of a lymph node. Lymph nodes are found throughout the body, and are part of the body’s immune system. These nodes help fight infection by producing special white blood cells called lymphocytes. They also work by trapping bacteria, viruses, and cancer cells.

Normally, lymph nodes cannot be felt unless they become swollen. Infection, usually by a virus, is the most common cause of lymph node swelling. Other causes include inflammatory disease, abscess, and cancer.

Parts of the Body Involved

Lymph nodes may be biopsied wherever they are enlarged and can be felt. Common areas for biopsy include:

  • Groin
  • Armpit
  • Neck
  • Under the jaw and chin
  • Behind the ears
  • On the back of the head

Reasons for Procedure

Lymph node biopsies are performed to find out why a node is swollen. This procedure is also used to see if there are cancer cells in the lymph node(s).

Risk Factors for Complications During the Procedure

Complications from a biopsy are rare. There is a small risk of bleeding or infection. If you have a bleeding problem, or take medication that causes increased bleeding, you may be at greater risk for complications. Pregnant women may also be at increased risk for complications.

What to Expect

Prior to Procedure

Depending on the type of lymph node biopsy, the procedure may be done in an operating room, an outpatient surgical facility, or a doctor’s office.

In the days leading up to your procedure you will need to:

  • Tell your doctor if you have any allergies
  • Sign a consent form
  • Inform your doctor of all medications you are taking, including any herbs, vitamins, or other supplements
  • Discuss your medical history with your doctor
  • Have nothing to eat or drink after midnight the day before your procedure, unless your doctor specifies otherwise
  • Arrange for a ride home
  • Wear comfortable clothes, especially near the biopsy site
  • Stop taking certain medications like aspirin or other blood thinning drugs

Anesthesia

Most biopsies are performed using a local anesthetic. Your doctor will inject a small needle with anesthetic into your skin to numb the area. You may feel some mild stinging. A sedative is sometimes given before the procedure.

General anesthesia is sometimes used for open biopsies. In this case, you may feel sleepy until the anesthesia wears off.

Description of the Procedure

Lymph nodes samples can be obtained by a needle biopsy or an open biopsy. There is also a procedure called a sentinel lymph node biopsy.

Needle Biopsy

There are two types of needle biopsies, fine needle biopsy, and core needle biopsy. A fine needle biopsy uses a thin, hollow needle to obtain fluid and tissue samples. A core needle biopsy uses a larger needle to cut a piece of tissue from the sample. Sometimes an ultrasound or computed tomography (CT) scan is used to help locate the biopsy site.

Lymph Node Biopsy

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Open Biopsy

An open biopsy means removing the lymph node(s) through an incision, or surgery. For this type of biopsy, a surgeon will cut into the skin and remove either the whole lymph node or part. More than one lymph node may be sampled. After removal, the incision is closed with stitches and bandaged. Either local or general anesthesia may be used, depending upon where the sample is taken.

Sentinel Lymph Node Biopsy

This type of biopsy is used to detect cancer. A sentinel lymph node is the first node or nodes, that cancer is expected to spread to from the primary tumor. For this biopsy, a special dye and a radioisotope tracer are placed near the tumor. The doctor then traces where the dye and isotopes go, and removes the lymph nodes the dye reaches first. These nodes are then checked for cancer. The benefit to this type of testing is that fewer lymph nodes may need to be removed.

After Procedure

After the procedure the tissue samples from the lymph node(s) are tested for the presence of infection or cancer. In some cases, the sample is sent to the lab during surgery for a quick test for cancer. This helps the surgeon determine if more samples need to be taken. A pathologist will prepare the sample and view it under a microscope for any abnormalities.

How Long Will It Take?

Depending upon the type of biopsy, the procedure can take from 30 minutes for a needle biopsy to an hour or longer for an open biopsy. If a CT scan or ultrasound is used, the procedure may take longer.

Will It Hurt ?

You will be given anesthesia to numb the area, and prevent pain during the procedure. You may feel some pressure or pinching during local anesthesia. If you feel any pain, tell your doctor at once. Some tenderness at the biopsy site is expected after the procedure.

Possible Complications

There are generally few complications after a lymph node biopsy. There is a small risk of bleeding or infection. Nerve damage including numbness at the biopsy site may occur.

If you received dye during a sentinel biopsy, you may experience discolored skin or urine. There is also a rare risk of allergic reaction to the dye.

Average Hospital Stay

Most lymph node biopsies are performed on an outpatient basis. A short stay in the hospital may be necessary in some cases.

Postoperative Care

Your doctor will give you specific instructions based upon where the biopsy was performed. General instructions include keeping the biopsy site clean and dry.

Outcome

Your biopsy will be sent to a pathologist to examine. Results are generally ready in a few days. Your doctor will give you the results from the test, and let you know if any further treatment is necessary.

Call Your Doctor If Any of the Following Occurs

It is important for you to monitor your recovery once you leave the hospital. If you notice any of the following, call your doctor:

  • Bleeding
  • Pain
  • Fever
  • Redness or swelling at biopsy site
  • Worsening symptoms
  • New symptoms that persist

RESOURCES:

American Cancer Society
http://www.cancer.org

National Cancer Institute
http://www.cancer.gov

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca

Cancer Care Ontario
http://www.cancercare.on.ca

References:

Lymph node biopsy. Medline Plus, US National Library of Medicine and the National Institutes of Health website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/003933.htm . Accessed August 29, 2005.

Testing biopsy and cytology specimens for cancer. American Cancer Society website. Available at: http://www.cancer.org/docroot/ped/content/ped_2_3x_testing_biopsy_and_cytology_specimens_for_cancer.asp?sitearea=ped . Accessed August 29, 2005.

Sentinel lymph node biopsy: questions and answers. National Cancer Institute website. Available at: http://cis.nci.gov/fact/7_44.htm . Accessed August 29, 2005.

Swollen glands. Medline Plus, US National Library of Medicine and the National Institutes of Health website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/003097.htm . Accessed August 30, 2005.

Zaret BL, Jatlow PI, and Katz LD. The Yale University School of Medicine Patient’s Guide to Medical Tests . New York: Houghton Mifflin Company; 1997.



Last reviewed March 2008 by Igor Puzanov, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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