How is a lymph node biopsy done?

Answer 1

A liver biopsy can be performed a few different ways: a needle can be inserted through the skin, and take a sample of the liver; during abdominal surgery, a piece of the liver may be removed; through blood vessels, a sample of the liver may be taken. the live sample would then be taken to be studied under a microscope.

Answer 2

There are three kinds of lymph node biopsy. Sentinel lymph node mapping and biopsy is a promising new technique that is discussed in its own entry. Fine needle aspiration (FNA) biopsy, often just called needle biopsy, is done when.

Answer 3

No particular preparation is necessary for a needle biopsy. For an open biopsy, patients need standard pre-operative blood tests and other tests to evaluate general health. The doctor should be informed about any medications.

Answer 4

A Doctor Who specializes in nuclear medicine first numbs the area around the tumor with a local anesthetic and then injects the radioactive technetium. He or she usually injects a blue dye as well.

Answer 5

Definition

Lymph node biopsy is a test in which a lymph node or a piece of a lymph node is removed for examination under a microscope.

The lymphatic system is made up of lymph nodes connected by lymph vessels. The nodes produce white blood cells (lymphocytes) that fight infections. When an infection is present, the lymph nodes swell, produce more white blood cells, and attempt to trap the organisms that are causing the infection. The lymph nodes also try to trap cancercells.

Alternative Names

Biopsy - lymph nodes

How the test is performed

The test is done in an operating room in a hospital, or at an outpatient surgical facility. There are two ways the sample may be obtained:

• Needle biopsy
• Open biopsy

A needle biopsy involves inserting a needle into a lymph node. You will lie on the examination table. The biopsy site will be cleansed, and the health care provider will inject a local anesthetic (numbing medication) into the area. The biopsy needle is then inserted into the node, and a sample is removed. Pressure is applied to the site to stop the bleeding, and a bandage is applied.

An open biopsy is surgery to remove all or part of the lymph node. You will lie on the examination table. You may be given a medicine to calm you and make you sleepy, if you prefer. The biopsy site will be cleansed, and the health care provider will inject a local anesthetic (numbing medication) into the area. (Occasionally, general anesthesia is used, which means you are asleep and pain-free.) A small surgical cut is made, and the lymph node or part of the node is removed. The area is closed with stitches and a bandage is applied.

The sample is then sent to the laboratory for examination.

How to prepare for the test

Tell your health care provider:

• If you are pregnant
• If you have any drug allergies
• If you have bleeding problems
• What medications you are taking (including any supplements or herbal remedies)

You must sign a consent form.

How the test will feel

When the local anesthetic is injected, there will be a prick and a mild stinging. The biopsy site will be sore for a few days after the test.

Why the test is performed

The test is used to help determine the cause of swollen glands. It may be done to find out if a lymph node tumor is cancerous (malignant) or noncancerous (benign).

Normal Values

Swollen lymph nodes may be caused by a number of conditions, ranging from very mild infections to cancer.

What abnormal results mean

Abnormal results may be due to many different conditions, from very mild infections to cancer.

For example, enlarged lymph nodes may be due to:

• Hodgkin's lymphoma
• Infection
• Non-Hodgkin's lymphoma
• Sarcoidosis

What the risks are

• Bleeding
• Infection
• Nerve injury if the biopsy is done on a lymph node close to nerves

Answer 6

Definition

A lymph node biopsy is the removal of lymph node tissue for examination under a microscope.

The lymph nodes are small glands that make white blood cells (lymphocytes), which fight infection. Lymph nodes may trap the germs that are causing an infection. Cancer can spread to lymph nodes.

Alternative Names

Biopsy - lymph nodes; Open lymph node biopsy; Fine needle aspiration biopsy; Sentinel lymph node biopsy

How the test is performed

A lymph node biopsy is done in an operating room in a hospital, or at an outpatient surgical facility. The biopsy may be done in different ways.

A needle biopsyinvolves inserting a needle into a lymph node.

• You will lie on the examination table. The biopsy site will be cleansed, and the health care provider will inject a local anesthetic (numbing medication) into the area.
• The biopsy needle is then inserted into the node, and a sample is removed. Pressure is applied to the site to stop the bleeding, and a bandage is applied.
• A fine needle aspiration biopsy usually takes less than 10 minutes. A needle biopsy only provides a small sample of cells. For cancers, this test may not be enough.

A needle biopsy may also be done during mediastinoscopy or bronchoscopy.

An open biopsy is surgery to remove all or part of the lymph node.

• You will lie on the examination table. You may be given a medicine to calm you and make you sleepy, if you prefer.
• The biopsy site will be cleansed, and the health care provider will inject a local anesthetic (numbing medication) into the area. (Occasionally, general anesthesia is used, which means you are asleep and pain-free.)
• A small surgical cut is made, and the lymph node or part of the node is removed. The area is closed with stitches and a bandage is applied.
• An open biopsy may take 30 - 45 minutes.

For some cancers, a special way of finding the best lymph node to biopsy is used. This is called sentinal lymph node biopsy, and it involves:

• A tiny amount of a tracer, either a radioactive tracer (radioisotope) or a blue dye, is injected into the tumor site.
• The tracer or dye flows into the sentinel node. This is the first lymph node to which any cancer would spread.
• The sentinal lymph node and possibly one or two other lymph nodes are removed.

The sample is then sent to the laboratory for examination.

How to prepare for the test

Tell your health care provider:

• If you are pregnant
• If you have any drug allergies
• If you have bleeding problems
• What medications you are taking (including any supplements or herbal remedies)

Your doctor may ask you to:

• Stop taking any blood thinners, such as aspirin, heparin, or warfarin 5 - 7 days before the procedure
• Not eat or drink anything after a certain period of time before the biopsy
• Arrive at a certain time for the procedure

You must sign a consent form.

How the test will feel

When the local anesthetic is injected, you will feel a prick and a mild stinging. The biopsy site will be sore for a few days after the test.

After an open biopsy, the pain is mild and you can easily control it with an over-the-counter pain medication. You may also notice some bruising or fluid leaking for a few days. The wound should heal in 10 - 14 days. During this time, avoid any type of intense exercise or heavy lifting.

Why the test is performed

The test is used to diagnose cancer or an infection:

• When you or your doctor feel swollen glands and they do not go away
• When lymph nodes are present on a CT or MRI scan
• For some patients with Breast cancer or melanoma, to see if the cancer has spread (sentinel lymph node biopsy)

The results of the biopsy help your doctor decide on further tests and treatments.

Normal Values

If a lymph node biopsy does not show any signs of cancer, it is more likely that other lymph nodes nearby are also cancer-free. This information can help the health care provider decide about further tests and treatments.

What abnormal results mean

Abnormal results may be due to many different conditions, from very mild infections to cancer.

For example, enlarged lymph nodes may be due to:

• Cancers (breast, lung, oral)
• Hodgkin's lymphoma
• Infection (tuberculosis, cat scratch disease)
• Non-Hodgkin's lymphoma
• Sarcoidosis

What the risks are

• Bleeding
• Infection (in rare cases, the wound may get infected and you may need to take antibiotics)
• Nerve injury if the biopsy is done on a lymph node close to nerves (the numbness usually goes away in a few months)

References

Carlson RW, Allred DC, Anderson BO, Burstein HJ, Carter WB, Edge SB, et al. Breast cancer. Clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2009;7:122-192.

Clinical practice guideline for melanoma: NCCN Medical Practice Guidelines and Oncology; V.2.2010. Available online.

Reviewed By

Review Date: 09/10/2010

Shabir Bhimji, MD, PhD, Specializing in Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Answer 7

A lymph node biopsy is a procedure in which all or part of a lymph node is removed and examined to determine if there is cancer within the node.

Answer 8

During the biopsy, a cylindrical piece of bone and marrow fluid is removed. They are generally taken out of the hipbone.

Answer 9

Under arm lymph node