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Neck lymph node ultrasound and biopsy

This test is also sometimes called a fine needle aspiration or needle biopsy.

You might have this test to find out if your cancer has spread from the salivary glands to the lymph nodes in your neck. You might have this test if your doctor has seen changes in the lymph nodes in your neck on a CT scan.

Diagram showing the lymph nodes in the head and 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.

Parts of the lymphatic system

What happens

Your doctor uses an ultrasound scanner to help them take a small amount of lymph node tissue using a fine needle.

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.

You normally have this test as an outpatient procedure in the imaging department of the hospital.

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.

Having the test

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 then numbs the area with local anaesthetic. They put a fine needle through your skin and draw back some cells and fluid into a syringe. Or they take out some tissue through a needle. They send the samples to a laboratory for tests 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

You should get your results within 1 or 2 weeks. Contact your doctor if you haven’t heard anything after this time.

Waiting for test results or for further tests can be very worrying. You might have contact details for a specialist nurse and you can contact them for information if you need to. It may help to talk to a close friend or relative about how you feel.

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

Possible risks

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.

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 biopsy site, let your doctor know straight away or go to your nearest accident and emergency department (A&E).

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.

Last reviewed: 
22 Oct 2019
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