Lymph nodes are small, oval-shaped organs located in different areas of your body. They are found close to internal organs such as the stomach, intestines, and lungs and are most commonly noted in the armpits, the groin, and the neck. Lymph nodes are part of your immune system and they help your body recognize and fight infections. A lymph node that becomes inflamed or infected can swell and appear as a lump underneath your skin.
Doctors may detect swollen or enlarged lymph nodes during a routine examination. Swollen lymph nodes that result from minor infections or insect bites typically do not require medical attention. However, your doctor may monitor and recheck your swollen lymph nodes after a few weeks. If your lymph nodes remain swollen or increase in size, your doctor may order a lymph node biopsy to look for evidence of a chronic infection, immune disorder, cancer, or a malignancy.
A lymph node biopsy is an outpatient procedure that can be performed at a hospital, in a doctor’s office, or in other medical facilities. A surgeon can remove the entire lymph node or take a tissue sample from the swollen lymph node. Once the sample is removed, it is sent to a pathologist, who examines the lymph node or tissue sample under a microscope
There are three ways to perform a lymph node biopsy.
This procedure takes approximately 10 minutes. While lying on an examination table, your doctor cleans the biopsy site and applies medication to numb the area. The doctor inserts a fine needle into your lymph node and removes a small cell sample. The doctor then removes the needle and applies a bandage.
This procedure removes either a portion of your lymph node or the entire lymph node. An open biopsy can be completed with local anesthesia, using a numbing medication applied to the biopsy site. You can also request general anesthesia in order to sleep through the procedure.
The entire procedure takes between 30 and 45 minutes. A surgeon makes a small cut, removes the lymph node, stitches the biopsy site, and applies a bandage. Pain is generally mild after an open biopsy and doctors may recommend over-the-counter pain medications. It takes approximately 10 to 14 days for the incision to heal. You should avoid strenuous activity and exercise while your incision heals.
If you have cancer, your doctor may perform a sentinel biopsy to determine where your cancer is likely to spread. Doctors inject a blue dye or tracer near the cancer site, which travels to the closest lymph node. Doctors then remove this lymph node and check the node for cancerous cells.
Before scheduling your lymph node biopsy, tell your doctor about any medications that you are taking. This includes non-prescription medications and supplements. Tell your doctor about any allergies to medication, latex allergies, pregnancies, or bleeding disorders.
Because a lymph node biopsy is a surgical procedure, stop taking prescription and non-prescription blood thinners at least five days before your scheduled procedure. Do not eat or drink several hours before your scheduled biopsy.
There are risks involved with any type of surgical procedure. Risks from a lymph node biopsy include:
- tenderness around the biopsy site
- numbness caused by nerve damage
Infection is relatively rare and can be treated with antibiotics. Numbness can occur if the biopsy is being performed in close proximity to nerves. Any numbness normally disappears within a couple of months.
Pain and tenderness can last for a few days after a biopsy. Once you return home, keep the biopsy site clean and dry at all times. Your doctor may ask that you avoid showers or baths for a couple of days after surgery. Additionally, closely monitor the biopsy site and your physical condition after surgery. Call your doctor if you show signs of an infection or complications, including:
- intense pain
- bleeding or discharge from the biopsy site
On average, test results are ready within seven days. Your doctor may call with the results or schedule a follow-up office visit. The test could potentially indicate that your lymph nodes are cancer-free. However, if cancer cells are detected in the biopsy, it could be a sign of one of the following conditions:
- Hodgkin’s and non-Hodgkin’s lymphoma
- breast cancer
- lung cancer
- oral cancer
Abnormal results can also signal an infection or immune system disorder, such as:
- HIV and other sexually transmitted diseases (syphilis and chlamydia)
- rheumatoid arthritis
- cat scratch fever
- infected tooth
- skin infections
After completing a lymph node biopsy and ruling out cancer, your doctor may order additional medical tests to determine the underlying cause of your enlarged lymph nodes.