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.

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

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 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.
• 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.

Images

Lymph node metastases, CT scan

Lymphatic system

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Review Date: 09/10/2010
Reviewed By: 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.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)