Lymph Node Biopsy

Dr Jesse Hu
Dr Jesse Hu
Senior Consultant General Surgeon, Breast, Thyroid & Endocrine Surgery

What Is A Lymph Node Biopsy?

A lymph node biopsy is a medical procedure that involves the removal of lymph node tissue to be examined under a microscope. Lymph nodes are small, bean-shaped structures that are part of the lymphatic system, which plays an important role in the body’s immune response.

Indications for Lymph Node Biopsy

These are the key indications for undergoing a lymph node biopsy:

Enlarged Lymph Nodes

Persistent or significantly enlarged lymph nodes, which may indicate an underlying condition such as infection, immune disorders, or cancer.

Diagnosis of Cancer

To confirm the diagnosis of lymphoma, leukemia, or metastasis of other cancers to the lymph nodes.

Infection

To identify specific infections that affect lymph node tissues, which might include tuberculosis or fungal infections.

Autoimmune Disorders

To diagnose conditions such as lupus or sarcoidosis, which can cause lymph node swelling and dysfunction.

Unexplained Symptoms

Such as prolonged fever, night sweats, or unexplained weight loss, where lymph node involvement is suspected.

Types of Lymph Node Biopsy

Lymph node biopsies can be performed using different techniques, and the main types include:

Fine Needle Aspiration (FNA)

This minimally invasive procedure involves using a thin needle to extract cells from the lymph node. FNA is typically used when the diagnosis requires only a sample of cells and not the entire lymph node structure.

Core Needle Biopsy

A larger needle is used in this technique to remove a small cylinder of tissue from the lymph node. This provides more tissue for analysis than FNA, allowing for a more comprehensive examination.

Excisional Biopsy

In this procedure, an entire lymph node or a substantial part of it is surgically removed. Excisional biopsies are often required when other biopsy methods do not provide enough information, or when a full lymph node examination is necessary for a definitive diagnosis.

Incisional Biopsy

Similar to an excisional biopsy, this method involves the removal of part of a lymph node. It is used when the node is too large to be completely removed or when only a section of the node is needed for diagnosis.

The Procedure

The procedure for a lymph node biopsy varies depending on the type of biopsy. Here is a detailed explanation of the steps involved in each method:

Preparation: The area around the lymph node is cleaned, and a local anaesthetic may be applied to numb the site.

Procedure: A thin needle is inserted into the lymph node, and a syringe is used to aspirate cells and fluids for analysis.

Duration: This procedure typically takes only a few minutes and is usually performed on an outpatient basis.

Preparation: Similar to FNA, the skin is cleansed, and local anaesthesia is administered.

Procedure: A larger needle, which can collect a core of tissue, is inserted into the lymph node. Several tissue samples may be taken.

Duration: This procedure also takes only a short time, and it is done on an outpatient basis.

Preparation: These procedures are often conducted in a hospital setting under local or general anaesthesia, depending on the size and location of the lymph node.

Procedure: An incision is made in the skin over the lymph node, and either part of the node (incisional) or the entire node (excisional) is removed.

Duration: The duration of these procedures can vary, typically lasting from 30 minutes to an hour, depending on the complexity and location of the lymph node.

Results from a lymph node biopsy are typically available within a few days to a week. A follow-up appointment is usually scheduled to discuss the results and next steps in treatment or further diagnostic testing, if necessary.

Risks and Complications

While a lymph node biopsy is generally safe, as with any medical procedure, there are potential risks and complications.

  • Infection: There is a small risk of infection at the biopsy site. Signs of infection include redness, swelling, warmth, and pus formation.
  • Bleeding: Minor bleeding at the biopsy site is common, but excessive bleeding can occasionally occur, requiring further medical intervention.
  • Nerve Damage: There is a risk of nerve injury, especially in biopsies of lymph nodes located near nerves, which can lead to numbness, tingling, or weakness in the affected area.
  • Scarring: Any procedure involving an incision may lead to scarring, though the extent varies depending on the size of the incision and the person’s healing process.
  • Allergic Reactions: Allergic reactions to anaesthesia or other medications used during the procedure may occur.

 

Patients undergoing a lymph node biopsy should discuss these risks with their doctor to understand how they apply to their specific situation.

Dr Jesse Hu

Dr Jesse Hu

Senior Consultant General Surgeon, Breast, Thyroid & Endocrine Surgery

Dr Jesse specialises in managing both benign and malignant breast and thyroid conditions, which also includes breast pain, breast lumps, breastfeeding problems, neck lumps, amongst others.

Her dual expertise in cancer removal and plastic surgery techniques expands the design of individualized treatments, leading to holistic patient outcomes.

Dr Jesse was part of the teaching faculties of both NUS Yong Loo Lin School of Medicine and Lee Kong Chian School of Medicine, where she teaches and mentors the next generation of medical students and trainee doctors.

  • Surgical training at NUS School of Medicine
  • FRCS (Fellow of the Royal College of Surgeons) Edinburgh, UK in 2014
  • Completed 2 Health Manpower Development Program (HMDP) fellowships at Oxford University Hospital, UK in 2016

Dr Jesse is recognized as an authority in breast cancer and thyroid surgery and a sought-after conference speaker.

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    Lymph Node Biopsy

    Frequently Asked
    Questions

    Is a lymph node biopsy painful?

    Patients may experience mild discomfort during and after the biopsy, but pain can usually be managed with over-the-counter pain relievers.

    Can I go home the same day after a lymph node biopsy?

    Most lymph node biopsies, particularly FNA and core needle biopsies, are outpatient procedures that allow patients to go home the same day.

    Can lymph node biopsies spread cancer?

    There is no evidence to suggest that needle biopsies spread cancer. Surgical techniques are designed to minimise any risk of spreading cancer cells.

    Are there alternatives to a lymph node biopsy for diagnosing conditions?

    Other diagnostic tests such as blood tests, imaging studies, or molecular assays might be considered, depending on the suspected condition.