If you have a swollen lymph node (gland) in your neck your doctor checks it with an ultrasound scan. If it looks abnormal they might take a biopsy. This means they use a thin needle to draw cells and fluid out of the lymph node. This is called a fine needle aspiration or needle biopsy.
They send the sample of cells to the laboratory to find out if they are cancerous.
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.
This short video is about lymph nodes and the lymphatic system.
The lymphatic system helps our bodies get rid of toxins, waste and other unwanted materials, including infections and cancer cells. It is a system of thin tubes called lymph vessels and lymph nodes or glands. These run throughout the body. The spleen, thymus, tonsils and adenoids are also part of the lymphatic system.
Along the lymph vessels are small, bean-shaped lymph glands. You might be able to feel these in your neck, under your arm and in your groin. But they are also throughout the body including the chest, abdomen and pelvis.
The lymphatic system carries a colourless liquid called lymph. As the blood circulates around the body, fluid passes from the blood into the body tissues, carrying food to the cells. This fluid bathes the tissues, to form tissue fluid, which collects waste products, bacteria, damaged cells and cancer cells if there are any. The fluid then drains back into the lymph vessels where it is transported towards the lymph glands. The glands then filter the lymph, taking out any harmful products. The lymph also contains lots of white blood cells, called lymphocytes, which help us fight infections.
The lymph eventfully reaches a large vessel at the base of the neck, called the thoracic duct which passes the filtered lymph back into the blood circulation. If the lymph vessels or nodes are blocked, removed or damaged, it can cause a build up of fluid. This can cause swelling, known as lymphoedema.
For more information about lymphoedema and cancers of the lymphatic system go to Cancer Research UK.org slash lymphoedema.
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.
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.
A lymph node biopsy is a safe procedure but your doctor or nurse will tell you who to contact if you have any problems after your test. Your doctors make sure the benefits of having a lymph node biopsy outweigh any possible risks.
You might have some mild pain or discomfort around the site. Taking a painkiller such as paracetamol can help.
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 biopsy site, let your doctor know straight away or go to your nearest accident and emergency department (A&E).
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.
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.