Testing your lymph nodes for mouth and oropharyngeal cancer

This test is called a fine needle aspiration or needle biopsy. Your doctor uses a fine needle and syringe to take a sample of cells from a lymph node in your neck.

A specialist doctor called a pathologist looks at the sample under the microscope to see if there are any cancer cells.

You might have this test if you have a swollen lymph node or lump on your neck.

What is a lymph node?

A lymph node is part of the lymphatic system. This is a network of thin tubes (vessels) and nodes that carry a clear fluid called lymph around the body. This is an important part of the immune system. It plays a role in fighting infection and destroying old or abnormal cells.

The nodes are bean shaped structures that filter the lymph fluid and trap bacteria and viruses, and cancer cells.

Why you might have a biopsy

You might have this test if your doctor can feel a lump in your neck. Your specialist will first feel the lump so they know where to put the needle. Or you might have an ultrasound scan of your neck. This can help your doctor find exactly where to put the needle to take the sample.

What is an ultrasound?

Ultrasound scans use high frequency sound waves to create a picture of a part of the body. The ultrasound scanner has a microphone that gives off sound waves. The sound waves bounce off the organs inside your body, and are picked up again by the microphone. The microphone links to a computer. This turns the sound waves into a picture.

Preparing for the test

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

You should be able to eat and drink normally before the test.

Take your medicines as normal unless you're told otherwise. If you're taking medicines to thin your blood, your doctor might ask you to stop them beforehand.

What happens

When you arrive at the department, a nurse might ask you to change into a gown. Then they show you to the test room.

You will have the test lying down on the couch. The doctor or a sonographer puts a cold lubricating gel on the skin by the lymph nodes. A sonographer is a trained professional who specialises in ultrasound scanning.

They put a handheld ultrasound probe on your skin. The gel helps the probe to move over your skin. You may feel a little pressure when they move the probe over your skin. Tell them if it is uncomfortable. It shouldn’t hurt.

This will be the end of your test if your lymph nodes look normal. Any changes on the ultrasound need looking into further.

If you need a biopsy, your doctor cleans your skin and may numb the area with local anaesthetic. They put a fine needle through your skin and using a syringe they pull up some cells and fluid. Or they take out some tissue through a needle. They send the samples to a laboratory to be looked at under a microscope.

The test takes about 15 to 20 minutes.

After your test

You should be able to go home the same day.

You have a small dressing over the site. Ask your doctor or nurse how to look after this for the next few days.

Getting your results

It takes 1 or 2 weeks to get the results. Your specialist will usually discuss them with you at your next clinic appointment.

Waiting for test results can be a worrying time. You might have contact details for a specialist nurse. You can get in touch with them for information and support if you need to. It may help to talk to a close friend or relative about how you feel. You may want them to go with you to get the results for support.

Possible risks

A fine needle aspiration is a very safe procedure but your nurse will tell you who to contact if you have any problems after your test. Your doctors will make sure the benefits of having this test outweigh these possible risks.

Pain

You might have some mild pain or discomfort around the site. Taking a painkiller such as paracetamol can help.

Bleeding

There is a small risk of bleeding. Your doctor can normally control this by pressing on the area. If there is a lot of blood from the site, let your doctor know straight away or go to the accident and emergency department of the hospital.

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.