What is a lymph node biopsy?
In a lymph node biopsy, one or more lymph nodes are removed from a specific area in a small operation. In some cases, only tissue from one lymph node can be removed. The samples are then examined histologically under a microscope by a pathologist. Lymph node biopsies are performed if there is a suspected degeneration of a lymph node or if a tumor has spread into the lymph nodes.
Indications
A lymph node biopsy is performed if so-called metastases are suspected or should be ruled out. A malignant tumor can spread along its lymphatic drainage system and affect the lymph nodes in the drainage area. Another reason for a lymph node biopsy may be a conspicuous lymph node.
If the enlargement is long, painless and very severe, it may be necessary to remove the lymph nodes to find out the cause of the enlargement. This could be caused by an infection or lymph node cancer (lymphoma). However, the removal is only for diagnostic purposes and is not performed as a therapeutic measure.
Preparation
Before a lymph node biopsy is performed, a detailed anamnesis should first be taken. If an enlargement of the lymph nodes has occurred, the patient should be asked how long it has existed, whether it has developed slowly or quickly and whether there are any other symptoms. Afterwards an imaging of the lymph node should be performed.
In most cases an ultrasound examination is sufficient. In rare cases, a CT or MRI examination can also be performed. The patient should then be informed about the procedure and the risks of the biopsy. In addition, an anesthesiologist should explain the form and risks of anesthesia.
Procedure
Depending on the location of the lymph node, the procedure can be performed either under local or general anesthesia. In the case of superficial lymph nodes, a local anesthesia, during which the patient is awake, may be sufficient. Deeper lymph nodes are removed under general anesthesia.
First, a skin incision is made and the lymph nodes are exposed. During this step, care is taken to protect surrounding vessels and nerves. The lymph node is then removed.
In the last step, the incoming and outgoing lymph channels are sclerosed and the skin layers are sutured in several steps. In larger wounds, the insertion of a drainage may be necessary to drain wound fluid from the wound. A bandage is applied over the surgical wound and the patient survives the procedure. The removed lymph nodes are placed in specific solutions for preservation and then sent to the pathology department for examination.
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