Patient education: Lymph node biopsy (The Basics)

What are lymph nodes? — 

These are small organs found all over the body, including the armpits, neck, and groin. They are part of a network of vessels called the "lymphatic system," which carries a clear fluid called "lymph" (figure 1 and figure 2). Lymph nodes filter the lymph and help the body fight infections and other diseases.

In a person with cancer, cancer cells sometimes spread through the lymphatic system and can be found in lymph nodes.

What is a lymph node biopsy? — 

This is a procedure to check abnormal lymph nodes. A biopsy looks at a sample of tissue or fluid. Doctors might remove all or part of a lymph node to help diagnose a problem. The doctors might check more than 1 node.

Some common reasons to have a lymph node biopsy include:

●To learn about a swollen node

●To see if cancer has spread to the nodes

●To check for a specific disease

●To help plan treatment for a medical problem

Some biopsies are done in a doctor's office or clinic. Others are done in an operating room or procedure area.

How do I prepare for a lymph node biopsy? — 

The doctor or nurse will tell you if you need to do anything special to prepare.

Your doctor will also ask about your "health history." This involves asking about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes prescription or "over-the-counter" medicines, plus any herbal supplements. It helps to write down and bring a list of your medicines, or bring a bag with all your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

Before the procedure, your doctor will do an exam. They might send you to get tests, such as:

●Blood tests

●Imaging tests, like a CT scan or ultrasound – These create pictures of the inside of the body.

You will also get information about:

●If you need to stop taking any medicines for a time before the procedure – Follow the doctor's instructions carefully.

●Eating and drinking before the procedure – You might need to "fast" before the procedure. This means not eating or drinking anything for a period of time. Or you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure.

●What help you will need when you go home – For example, you might need someone else to bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during a lymph node biopsy? — 

It depends on the type of biopsy.

Your doctor will recommend which type of biopsy to have, and where to have it, based on:

●Your health and medical problems

●Why you are getting the biopsy

●The size and location of the abnormal node

●How the node looks on ultrasound or other imaging tests

When it is time for the procedure:

●You might get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●You will get an injection (shot) to numb the area. You might also get "sedative" medicines to help you relax and feel sleepy.

●The main types of lymph node biopsies are:

•Needle biopsy – It might also be called a "fine-needle biopsy" or "core needle biopsy," depending on the size and type of needle. The doctor will clean and numb your skin over your lymph node. They might use an ultrasound to help them find the node and guide where to put the needle. They will use the needle to remove a small sample of cells from your node. Then, they will remove the needle. You might have less problems with bruising, bleeding, or infection with a needle biopsy than with a surgical biopsy.

•Surgical biopsy, also called open biopsy – This is done in an operating room under anesthesia. General anesthesia makes you unconscious or very sleepy so you can't feel, see, or hear anything during the procedure. The doctor will make a small cut ("incision") over your lymph node. Then, they will either take a small sample of tissue from it or remove it entirely.

•Sentinel lymph node biopsy – This is also done in an operating room under anesthesia. The doctor will usually do this biopsy as part of another surgery for cancer, like a lumpectomy for breast cancer. When cancer cells spread, they usually first travel through the lymph to 1 or more nearby lymph nodes. These are called "sentinel lymph nodes." During a sentinel lymph node biopsy, the doctor will use a dye or other substance to find the sentinel lymph nodes. Then, they will make a small incision, take out these nodes, and check them for cancer cells. By checking only the sentinel lymph nodes, they do not have to check all the other lymph nodes to see if the cancer spread. This information helps them plan treatment.

●After the biopsy, the doctor will hold pressure or use stitches, skin glue, or medical tape to close any incisions and stop any bleeding. If needed, they will cover the area with clean bandages.

●Most lymph node biopsies take between 15 and 60 minutes.

What happens after a lymph node biopsy? — 

If you had anesthesia, the staff will watch you closely as it wears off.

You will likely get your biopsy results in about 1 to 2 weeks. Your doctor will talk to you about what the results mean and what will happen next. If the results are not clear, your doctor will schedule another biopsy or procedure to get more information.

What are the risks of a lymph node biopsy? — 

Your doctor will talk to you about all the possible risks and answer your questions. Possible risks include:

●Bleeding or bruising

●Infection

●Injury to nearby nerves or organs

●Swelling

●Collection of fluid under the skin

More on this topic

Patient education: Lymph node biopsy – Discharge instructions (The Basics)
Patient education: Sentinel lymph node biopsy for breast cancer (The Basics)
Patient education: Swollen lymph nodes in adults (The Basics)
Patient education: Swollen neck nodes in children (The Basics)
Patient education: Lymphoma (The Basics)

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