Lymph node biopsy

A lymph node biopsy is the only way to find out for sure why a lymph node is swollen. It is a simple operation. Your doctor removes part or all of the lymph node. They send it to the laboratory for a specialist to look at it under a microscope. 

Preparing for your biopsy

Check your appointment letter for how to prepare for your biopsy. You will sign a consent form before you have the test. This is a good time to ask the doctor any questions. 

Local anaesthetic

You can usually eat and drink as normal before the biopsy if you’re having a local anaesthetic.

You usually have a local anaesthetic for swollen lymph nodes close to the surface of your body that are easy to reach. Your doctor gives you an injection to numb the area around the lymph node.

General anaesthetic

You usually can't eat for about 6 hours before you have a general anaesthetic. You may be able to drink water up to 2 hours before the operation.

You usually have a general anaesthetic for lymph nodes that are deeper in your body. This means you are asleep for the procedure.

Types of biopsy

Excision biopsy

Your doctor will remove the whole enlarged node if it is near the surface of your skin. This is called an excision biopsy. Lymph nodes are part of our lymphatic system and run throughout our bodies. Removing 1 or 2 doesn't usually cause any problems.

You have the biopsy under local or general anaesthetic. It is a small operation that most people have as a day case.

Ultrasound or CT guided core biopsy 

For enlarged lymph nodes deeper in your body, your doctor might take a sample of tissue from the node using a needle. You'll need to have an ultrasound scan or CT scan. Your doctor uses one of these to guide the needle.

This is called an ultrasound or CT guided core biopsy. You usually have this under local anaesthetic in the radiology department.

During the biopsy

Your doctor makes a small cut above the swollen lymph node and removes it. They send this to the laboratory where a pathologist looks at it under a microscope.

Your doctor closes the cut with a couple of stitches. They usually cover it with a small dressing.

After the biopsy

Your nurse will check your blood pressure, pulse, oxygen levels, temperature and your wound after the biopsy.

It will take you several hours to recover from a general anaesthetic. You can normally start drinking as soon as you are awake, and eating once you are hungry and don't feel sick.

Most people go home the same day as the biopsy. After a local anaesthetic you can usually go home shortly afterwards. If you've had a general anaesthetic, you'll need someone to take you home and stay with you for the first 24 hours.

Your nurse will tell you how to look after the wound over the next few days. You'll need to go back to the hospital or your GP surgery about 7 to 10 days later to have your stitches out. The area around the wound may be swollen, bruised and tender for a few days.

Getting your results

You usually get the results within 2 weeks. The doctor who arranged the biopsy will give them to you.

Sometimes, the exact type of lymphoma can be difficult to diagnose. Other special tests might be done on the sample in the laboratory, which may take a little longer. Occasionally a second biopsy might be needed to confirm the diagnosis.

Waiting for test results can be worrying. It may help to talk to a close friend or relative about how you feel.

Possible risks

A lymph node biopsy is a safe procedure but your nurse will tell you who to contact if you have any problems after your test. 

Pain
You may have some mild pain or discomfort around the site. Taking a painkiller, such as paracetamol can help. Contact the hospital if you still have pain more than a week afterwards.

Infection
Contact your GP or the hospital if you have a high temperature or feel unwell. Or if there is redness, swelling or fluid (discharge) at the biopsy site.

Bleeding
There is a small risk of bleeding. Your nurse can normally stop this by pressing on the area. If there is a lot of blood from the biopsy site once you are at home, contact the hospital straight away or go to A&E.