A lymph node
biopsy removes lymph node tissue to be looked at under a microscope
for signs of infection or a disease, such as cancer. Other tests may also be
used to check the lymph tissue sample, including a
culture, genetic tests, or tests to study the body's
immune system (immunological tests).
Lymph nodes are part of the immune system. They are found in the neck,
behind the ears, in the armpits, and in the chest, belly, and groin.
Lymph nodes in healthy people are usually hard to
feel. But lymph nodes in the neck, armpit, or groin can get bigger and become
tender. Swollen lymph nodes usually mean an infection, but the swelling can
also be caused by a cut, scratch, insect bite, tattoo, a drug reaction, or
There are several ways to do a lymph node biopsy. The
lymph node sample will be looked at under a microscope for problems.
Lymph node biopsy is done to:
Tell your doctor if you:
You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.
Talk to your
doctor about any concerns you have regarding the need for the biopsy, its
risks, how it will be done, or what the results will mean. To help you
understand the importance of the biopsy, fill out the
medical test information form(What is a PDF document?).
If you take a blood thinner, you will
probably need to stop taking it for a week before the biopsy.
lymph node biopsy will be done under
local anesthesia, you do not need to do anything else
to prepare for the biopsy.
If the biopsy will be done under
general anesthesia, follow the instructions exactly
about when to stop eating and drinking, or your surgery may be canceled. If
your doctor has instructed you to take your medicines on the day of surgery, do
so using only a sip of water. An
intravenous line (IV) will be put in your arm, and a
sedative medicine will be given before the biopsy.
Arrange for someone to drive you home if you are going to have general
anesthesia or will be given a sedative.
Other tests, such as blood
X-rays, may be done before the lymph node
A needle biopsy of a
lymph node near the skin is usually done by a
radiologist, or a
general surgeon. A needle biopsy of a lymph node
deeper within the body is usually done by a radiologist using a
CT scan or
ultrasound to help guide the needle. The biopsy may be
done in a surgery clinic or the hospital.
You will need to take
off all or most of your clothes. (You may be allowed to keep on your underwear
if it does not interfere with the biopsy.) You will be given a cloth or paper
covering to use during the biopsy.
Your doctor numbs the area of
your breast where the needle will be inserted. Once the area is numb, the
needle is put through the skin and into the lymph node. You must lie still while the
biopsy is done. The biopsy sample is
sent to a lab to be looked at under a microscope.
The needle is then removed. Pressure is put on the
needle site to stop any bleeding. A bandage is put on. A fine-needle aspiration
biopsy takes about 5 to 15 minutes.
A core needle biopsy is usually
done by a general surgeon or radiologist.
Your doctor numbs the area of
your breast where the needle will be inserted. Once the area is numb, a small
cut is made in the skin. A needle with a special tip is put through the skin
and into the lymph node. You must lie still while the biopsy is done.
The needle is then removed. Pressure is put on the needle site to stop
any bleeding. A bandage is put on. A core needle biopsy takes about 20
biopsy of a lymph node is done by a surgeon. For a lymph node near the surface
of the skin, the biopsy site is numbed with local anesthetic. For a lymph node
deeper in the body or for lymph node dissection, you may have general
You will need to take off all or most of your clothes.
(You may be allowed to keep on your underwear if it does not interfere with the
biopsy.) You will be given a cloth or paper covering to use during the biopsy.
Your hands may be at your sides or raised above your head (depending on which
position makes it easiest to find the lymph node).
You will lie on
an examining table and the skin over the biopsy site will be cleaned with a
special soap. The area is covered with a sterile sheet. A small cut will be
made so the whole lymph node or a slice of it can be taken out.
Stitches are used to close the skin, and a bandage is put on. You will be
taken to a recovery room until you are fully awake. You can usually return to
your normal activities the next day.
An open biopsy usually takes
from 30 to 60 minutes. If you have had a lymph node dissection to remove
cancer, the surgery may take longer.
You will feel only a quick sting from
the needle if you have a local anesthesia to numb the biopsy area. You may feel
some pressure when the biopsy needle is put in. After a fine-needle aspiration
biopsy or core needle biopsy, the site may be tender for 2 to 3 days. You also
may have a bruise around the site.
If you have general anesthesia
for an open lymph node biopsy, you will not be awake during the biopsy. After
you wake up, the area may be numb from a local anesthetic that was put into the
biopsy site. You will also feel sleepy for several hours.
For 1 to
2 days after an open lymph node biopsy, you may feel tired. You may also have a
mild sore throat if a tube was used to help you breathe during the biopsy.
Using throat lozenges and gargling with warm salt water may help with the sore
After an open biopsy, the area may feel tender, firm,
swollen, and bruised. Fluid may collect near the biopsy site. Fluid may
also leak from the biopsy site. You can use an ice pack or take an over-the-counter pain medicine (not aspirin) to help relieve swelling and mild pain. The tenderness should go away in
about a week, and the bruising usually fades within 2 weeks. But the firmness
and swelling may last for 6 to 8 weeks. Do not do any heavy lifting or other
activities that stretch or pull the muscles around the area.
There is a chance of an infection at the biopsy
site. An infection can be treated with
Call your doctor immediately
A lymph node
lymph node tissue to be looked at under a microscope
for signs of infection or a disease, such as cancer. Test results from a lymph
node biopsy are usually available within a few days. Finding some types of
infections may take longer.
The lymph node sample is usually
treated with special dyes (stains) that color the cells and make problems more
The lymph node has normal numbers of lymph
The structure of the lymph node and the
appearance of the cells in it are normal.
No signs of infection are
Signs of infection, such as
mononucleosis (mono) or
tuberculosis (TB), may be present.
Cancer cells may be present. Cancer may
begin in the lymph node, such as
Hodgkin's lymphoma, or may have spread from other
sites, such as in
metastatic breast cancer.
A needle biopsy takes tissue
from a small area, so there is a chance that a cancer may be missed.
Other Works ConsultedChernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
March 29, 2011
Sarah Marshall, MD - Family Medicine & C. Dale Mercer, MD, FRCSC, FACS - General Surgery
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