Lymph node biopsy

Lymph node biopsy is done to:

• Check the cause of enlarged lymph nodes that do not return to normal size on their own.
• Check the cause of symptoms, such as an ongoing fever, night sweats, or weight loss.
• Check to see if a known cancer has spread to the lymph nodes. This is called staging and is done to plan cancer treatment.
• Remove cancer.

A lymph node biopsy may be done in a surgery clinic or the hospital.

You may need to take off all or some of your clothes. If needed, you will be given a cloth or paper covering to use during the biopsy.

In a fine needle lymph node biopsy, your doctor numbs the area where the needle will be inserted. When the area is numb, the needle is put through the skin and into the lymph node to remove a sample of cells. You must lie still while the biopsy is done.

The needle is then removed. Pressure is put on the needle site to stop any bleeding. A bandage is put on.

The biopsy sample is sent to a lab to be looked at under a microscope.

In a core needle lymph node biopsy, your doctor numbs the area where the needle will be inserted. When the area is numb, a small cut is made in the skin. A needle with a special tip is put through the skin and into the lymph node to remove a sample of tissue. You must lie still while the biopsy is done.

The needle is then removed. Pressure is put on the needle site to stop any bleeding. A bandage is put on.

An open biopsy of a lymph node is done by a surgeon. For a lymph node near the surface of the skin, the biopsy site is numbed with local anesthetic. For a lymph node deeper in the body or if more than one lymph node will be taken (lymph node dissection), you may have general anesthesia. That means you will not be awake during the biopsy.

An intravenous line (I.V.) will be put in your arm, and a sedative medicine will be given before the biopsy.

A small cut will be made so the whole lymph node or a slice of it can be taken out.

Stitches are used to close the skin, and a bandage is put on. You will be taken to a recovery room until you are fully awake. After you wake up, the area may be numb from a local anesthetic that was put into the biopsy site. You will also feel sleepy for several hours.

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

• If the biopsy will be done under general anesthesia, follow the instructions exactly about when to stop eating and drinking, or your biopsy may be canceled. If your doctor has instructed you to take your medicines on the day of the biopsy, do so using only a sip of water.
• If a lymph node biopsy will be done under local anesthesia, you don't need to do anything else to prepare for the biopsy.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your test. Your doctor will tell you if you should stop taking any of them before the test and how soon to do it.
• If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your surgery. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.

Other tests, such as blood tests or X-rays, may be done before the lymph node biopsy.

Results are usually available within a few days. Finding some types of infections may take longer.

The lymph node sample is usually treated with special dyes (stains) that color the cells so problems can be clearly seen.

Normal

• The lymph node has normal numbers of lymph node cells.
• The structure of the lymph node and the cells look normal.
• No signs of infection are present.

Abnormal

• Signs of infection, such as mononucleosis (mono) or tuberculosis (TB), may be present.
• Cancer cells may be present. Cancer may begin in the lymph node, such as Hodgkin lymphoma, or may have spread from other sites, such as in metastatic breast cancer.