Lymph node biopsy

You have this test to find out why a lymph node is swollen. Your doctor removes part or all of a lymph node, which is then tested to see if it contains non Hodgkin lymphoma cells. 

What it is

In this simple operation, your doctor removes part or all of a lymph node. They send it to the laboratory, where a pathologist looks at it under the microscope to see if it contains non Hodgkin lymphoma cells. 

Why you have it

A lymph node biopsy is the only way to find out for sure why a lymph node is swollen. If there are non Hodgkin lymphoma cells, the pathologist can also find out which type they are. 

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.

Diagram showing a lymph node

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. 

If you normally take medicines to thin your blood, your doctor might ask you to stop them before your biopsy.

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.

How you have it

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 the microscope.

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

Excision biopsy

If the enlarged node is near the surface of your skin, the doctor is likely to remove the whole node. This is called an excision biopsy. Your body has many lymph nodes. Removing 1 or 2 does not usually cause any problems.

Needle biopsy

If the enlarged lymph node is deeper in your body, the doctor might take a sample of tissue from the node using a needle. They might use an ultrasound scan or CT scan to help guide the needle. This is also called an ultrasound or CT guided core biopsy.

You usually have this under local anaesthetic in the hospital’s radiology department. Your doctor puts a fine needle through your skin and draws back some cells and fluid into a syringe. Or they take out some tissue through the needle. This takes about 15 to 20 minutes.

After your biopsy

The nurse checks your blood pressure, pulse, oxygen levels, temperature and wound.

It takes 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. If you had a local anaesthetic you can usually go home shortly afterwards. If you had a general anaesthetic, you need someone to take you home and stay with you for the first 24 hours.

Your nurse tells you how to look after your wound. You have 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 might 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.

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

For support and information, you can call the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday.

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. 

Mild pain

You might 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
  • you feel unwell
  • 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.

Contact the hospital straight away or go to the accident and emergency department if there is a lot of blood from the biopsy site once you are at home.

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