Lymph Node Biopsy in Chandigarh: Procedure, Benefits & More

Lymph node biopsy is a diagnostic test that helps to identify or evaluate the diseases of the lymph nodes. Lymph nodes are small, oval, or bean-shaped organs present in your body that are a part of your immune system and possess the ability to fight off infections. These are present throughout your body, including the armpits, neck, groins, stomach, intestines, and lungs. 

Enlargement of the lymph nodes indicates the presence of any infection in your body that needs further evaluation to rule out underlying problems. Thus, your surgeon may recommend a lymph node biopsy to look for signs of any chronic (long-lasting) infection, an immune disorder (a condition when your immune system fails and in turn attacks the healthy cells in your body), or cancer.

A lymph node biopsy is a diagnostic procedure that involves the removal of a piece of tissue or a sample of cells from your lymph nodes and is later sent to the laboratory, where a pathologist studies the sample under a microscope. There are three ways in which a lymph node biopsy can be performed:

• Needle biopsy: Involves the removal of a small sample of cells from your lymph nodes using a needle with a special tip.
• Open biopsy: Involves the removal of either a portion of your lymph node or the complete lymph node.
• Sentinel biopsy: This procedure is done to check the spread of cancer to other areas.

A lymph node biopsy is recommended if:

• You have persistent enlargement which is not responsive to antibiotics.
• A particular area shows signs of inflammation, pain, or enlargement.
• The enlargement is painless without overlying skin infection.
• Your surgeon must rule out other underlying problems like cancer and its spread to other parts of your body.

It is important to prepare yourself well in advance before a lymph node biopsy to prevent errors during the investigation and diagnosis. 

• Inform your surgeon about your medical history like diabetes (increased blood sugar levels), hypertension (high blood pressure), etc., and the medications being taken (herbal supplements, blood thinners) before the biopsy is conducted.
• Consume a healthy diet and hydrate yourself well a few days before the biopsy.
• However, you are advised to fast for 4 to 5 hours before the procedure (if done under general anesthesia).
• Avoid taking medications like aspirin, and blood thinners at least 5 days before the procedure.
• Avoid alcohol for 5 to 7 days before the biopsy. 
• Avoid using chemicals like body lotions, sprays, and talcum powder 24 to 48 hours before the test.
• Arrange someone to drive you back home after the procedure.

A lymph node biopsy is an outpatient (does not require hospitalization) procedure that usually takes 30 to 45 minutes depending on the type of biopsy. 

Firstly, you are made to lie on an operating table and the biopsy site is cleansed with an antiseptic solution.

Open biopsy

• This is done under general anesthesia.
• A small incision (cut) is made at the biopsy site and a part or entire lymph node is removed.
• The cut is closed using stitches and a surgical bandage is placed over it.

Needle biopsy

• Needle biopsy is done under local anesthesia.
• Here a small syringe with a specialized needle is used. 
• The needle is carefully inserted to extract the sample tissue. 
• This is usually performed by a radiologist using ultrasound or CT (Computed Tomography) scan to locate the node.

Sentinel biopsy 

• This is usually used for cancer patients where a small amount of tracer or a blue dye or both are injected into the biopsy site or tumor area.
• The dye flows to the nearest nodes known as the sentinel nodes. These are the first nodes to which cancer may spread.
• The sentinel nodes are removed and sent to the laboratory for evaluation.

Biopsy using a laparoscope

• This is usually performed for biopsies in the stomach.
• Tiny keyhole-sized incisions (cuts) are made and a laparoscope is inserted into one of the cuts into the abdomen. A Laparoscope is a device that consists of a small, thin tube with a camera and a light source.
• The laparoscope projects images on a big screen to help the surgeon locate the node.
• Tiny surgical instruments are inserted through other cuts to remove the node.
• Once the sample or the node is removed, it is sent to the laboratory where a pathologist studies the sample under a microscope.
• You will be kept under observation for 1 to 2 hours and then allowed to go home.
• You may get the results the same day for a needle biopsy.
• Open biopsy results may take around 7 to 10 days.

The biopsied area is likely to be covered by a protective dressing which will stay on for 2 to 3 days, and your healthcare provider will give you instructions on how to care for the area.

• You may experience pain and tenderness for a few days after the biopsy. This can be managed with pain relief medications.
• Avoid showers or tub baths for a few days to keep the area clean and dry, which helps to prevent infections.
• Avoid lifting heavy objects and strenuous activities for at least 2 to 3 days after the biopsy.
• The area should be monitored for any bleeding, swelling, redness, pus discharge, or fever (above 104 degrees). Contact your doctor immediately if you notice any such symptoms.

Benefits

• Lymph node biopsy can be performed by various techniques depending on the need and lymph nodes involved.
• It is helpful in diagnosing any underlying cause which is otherwise unknown.
• It is a minimally invasive procedure with less pain, bleeding and trauma to the surrounding structures.
• Lymph node biopsies also help determine the cancer stage and treatment modality.

Risks 

• An increased risk of infections can be managed through antibiotics.
• Mild pain and discomfort around the biopsy site, which may resolve by using pain relief medications.
• Risk of bleeding around the biopsy site.
• Fluid build-up where the lymph node was removed and is known as a seroma. This may take some time to settle down, or the excess fluid may be drained by your doctor.
• You are likely to develop a condition known as lymphedema (a swelling caused due to build-up of lymph fluid), several months after the biopsy.
• Mild numbness caused by nerve damage in the region where the biopsy sample was taken.

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