Lymph nodes are small, oval-shaped organs located in different regions 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 to recognize and fight off infections. A lymph node may swell in response to an infection somewhere in your body. Swollen lymph nodes can appear as a lump underneath your skin.
Your doctor may find swollen or enlarged lymph nodes during a routine examination. Swollen lymph nodes that result from minor infections or insect bites typically don’t require medical attention. However, your doctor may monitor and check your swollen lymph nodes after a few weeks. If your lymph nodes remain swollen or grow even larger, 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 take place at a hospital, in your doctor’s office, or in other medical facilities. A doctor can remove the entire lymph node or take a tissue sample from the swollen lymph node. Once the doctor removes the sample, they send it to a pathologist, who examines the lymph node or tissue sample under a microscope.
There are three ways to perform a lymph node biopsy.
A needle biopsy takes about 10 to 15 minutes. While you’re lying on an examination table, your doctor will clean the biopsy site and apply medication to numb the area. Your doctor will insert a fine needle into your lymph node and remove a small sample of cells. They’ll then remove the needle and put a bandage on the site.
This procedure removes either a portion of your lymph node or the entire lymph node. Your doctor can perform an open biopsy with local anesthesia, using a numbing medication applied to the biopsy site. You can also request general anesthesia to sleep through the procedure.
The entire procedure takes between 30 and 45 minutes. Your doctor will:
- make a small cut
- remove the lymph node
- stitch the biopsy site
- apply a bandage
Pain is generally mild after an open biopsy, and your doctor may recommend over-the-counter pain medications. It takes about 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. In this procedure, your doctor will inject a blue dye or tracer near the cancer site, which travels to the closest lymph node. Your doctor will then remove this lymph node and check it for cancerous cells.
There are risks involved with any type of surgical procedure. Notable risks from a lymph node biopsy include:
- tenderness around the biopsy site
- numbness caused by incidental nerve damage
Infection is relatively rare and can be treated with antibiotics. Numbness can occur if the biopsy is in close proximity to nerves. Any numbness normally disappears within a couple of months.
Before scheduling your lymph node biopsy, tell your doctor about any medications that you’re taking. This includes non-prescription medications such as aspirin or other blood thinners and supplements. Tell your doctor if you’re pregnant, and tell them about any medication allergies, latex allergies, 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. Don’t eat or drink several hours before your scheduled biopsy.
Pain and tenderness can last for a few days after a biopsy. Once you get home, keep the biopsy site clean and dry at all times. Your doctor may ask you to avoid showers or baths for a couple of days after the surgery. You should also pay close attention to 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 five to seven days. Your doctor may call you with the results, or you may need to schedule a follow-up office visit. The test could potentially indicate that your lymph nodes do not have signs of cancer. However, if cancer cells are detected in the biopsy, it could be a sign of one of the following conditions:
- Hodgkin’s lymphoma
- non-Hodgkin’s lymphoma
- breast cancer
- lung cancer
- oral cancer
Abnormal results can also mean you have an infection or immune system disorder, such as:
- HIV or another sexually transmitted disease, such as syphilis or chlamydia
- rheumatoid arthritis
- cat scratch fever
- an infected tooth
- a skin infection
- systemic lupus erythematosus (SLE), or lupus
If your doctor completes a lymph node biopsy and rules out cancer, they may order additional medical tests to determine the underlying cause of your enlarged lymph nodes.
Talk with your doctor if you have questions about the results of your lymph node biopsy. If your doctor believes you need further medical tests, carefully review the procedure for the tests so that you can eliminate any doubts or questions beforehand.