Lymph node biopsy
Encyclopedia
Lymph node biopsy is a test in which a lymph node
or a piece of a lymph node is removed for examination under a microscope
(see: biopsy
).
The lymphatic system
is made up of several lymph nodes connected by lymph vessel
s. The nodes produce white blood cells (lymphocytes) that fight infection
s. When an infection is present, the lymph nodes swell, produce more white blood cells, and attempt to trap the organisms that are causing the infection. The lymph nodes also try to trap cancer
cells.
, or at an outpatient surgical facility
. There are two ways the sample may be obtained:
The patient lies on the examination table; the biopsy site is cleansed; and a local anesthetic is injected. The biopsy
needle is then inserted into the node. A sample is removed, pressure is applied to the site to stop the bleeding
, and a bandage is applied.
The patient lies on the examination table and is given a sedative
. The skin
over the biopsy site is cleansed, and a local anesthetic is injected (occasionally, a general anesthetic is given). A small incision is made, and the lymph node or part of the node is removed. The incision is then closed with stitches and bandage
d.
The sample is then sent to pathology
.
With this test there is a small chance of infection
or bleeding
. Additionally, there is a moderate risk of nerve
injury, localized paralysis
, or numbness
when the biopsy is performed on a lymph node close to nerve
s.
s in the lymph node are cancer
ous or noncancerous. Enlarged lymph nodes may be caused by a number of conditions, ranging from very mild infection
s to serious malignancies
. Benign
conditions can often be distinguished from cancerous and infectious processes by microscopic examination. The pathologist may also perform additional tests on the lymph node tissue to assist in making a diagnosis
.
Some of the conditions where abnormal values are obtained are:
Lymph node
A lymph node is a small ball or an oval-shaped organ of the immune system, distributed widely throughout the body including the armpit and stomach/gut and linked by lymphatic vessels. Lymph nodes are garrisons of B, T, and other immune cells. Lymph nodes are found all through the body, and act as...
or a piece of a lymph node is removed for examination under a microscope
Microscope
A microscope is an instrument used to see objects that are too small for the naked eye. The science of investigating small objects using such an instrument is called microscopy...
(see: biopsy
Biopsy
A biopsy is a medical test involving sampling of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically...
).
The lymphatic system
Lymphatic system
The lymphoid system is the part of the immune system comprising a network of conduits called lymphatic vessels that carry a clear fluid called lymph unidirectionally toward the heart. Lymphoid tissue is found in many organs, particularly the lymph nodes, and in the lymphoid follicles associated...
is made up of several lymph nodes connected by lymph vessel
Lymph vessel
In anatomy, lymph vessels are thin walled, valved structures that carry lymph. As part of the lymphatic system, lymph vessels are complementary to the cardiovascular system. Lymph vessels are lined by endothelial cells, and deep to that have a thin layer of smooth muscles, and adventitia that bind...
s. The nodes produce white blood cells (lymphocytes) that fight infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
s. When an infection is present, the lymph nodes swell, produce more white blood cells, and attempt to trap the organisms that are causing the infection. The lymph nodes also try to trap cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
cells.
How the test is performed
The test is done in an operating room in a hospitalHospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
, or at an outpatient surgical facility
Outpatient surgery
Outpatient surgery, also known as ambulatory surgery, same-day surgery or day surgery, is surgery that does not require an overnight hospital stay. The term “outpatient” arises from the fact that surgery patients may go home and do not need an overnight hospital bed...
. There are two ways the sample may be obtained:
- Needle biopsy
- Open (excisionExcisionExcision is the alias of Jeff Abel, a dubstep DJ and music boss from British Columbia, Canada. He frequently works with fellow Canadian dubstep producers Datsik and Downlink. As one of the first dubstep producers and DJs in North America, he has played a significant role in the genre's growth in...
al) biopsy
Needle biopsy
A needle biopsy involves inserting a needle into a node to obtain the sample.The patient lies on the examination table; the biopsy site is cleansed; and a local anesthetic is injected. The biopsy
Needle aspiration biopsy
Needle aspiration biopsy , may refer to fine needle aspiration cytology , fine needle aspiration biopsy and fine needle aspiration , is a diagnostic procedure sometimes used to investigate superficial lumps or masses...
needle is then inserted into the node. A sample is removed, pressure is applied to the site to stop the bleeding
Bleeding
Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood or blood escape from the circulatory system...
, and a bandage is applied.
Open biopsy
An open biopsy consists of surgically removing all or part of a node.The patient lies on the examination table and is given a sedative
Sedative
A sedative or tranquilizer is a substance that induces sedation by reducing irritability or excitement....
. The skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
over the biopsy site is cleansed, and a local anesthetic is injected (occasionally, a general anesthetic is given). A small incision is made, and the lymph node or part of the node is removed. The incision is then closed with stitches and bandage
Bandage
A bandage is a piece of material used either to support a medical device such as a dressing or splint, or on its own to provide support to the body; they can also be used to restrict a part of the body. During heavy bleeding or following a poisonous bite it is important to slow the flow of blood,...
d.
The sample is then sent to pathology
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....
.
With this test there is a small chance of infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
or bleeding
Bleeding
Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood or blood escape from the circulatory system...
. Additionally, there is a moderate risk of nerve
Nerve
A peripheral nerve, or simply nerve, is an enclosed, cable-like bundle of peripheral axons . A nerve provides a common pathway for the electrochemical nerve impulses that are transmitted along each of the axons. Nerves are found only in the peripheral nervous system...
injury, localized paralysis
Paralysis
Paralysis is loss of muscle function for one or more muscles. Paralysis can be accompanied by a loss of feeling in the affected area if there is sensory damage as well as motor. A study conducted by the Christopher & Dana Reeve Foundation, suggests that about 1 in 50 people have been diagnosed...
, or numbness
Paresthesia
Paresthesia , spelled "paraesthesia" in British English, is a sensation of tingling, burning, pricking, or numbness of a person's skin with no apparent long-term physical effect. It is more generally known as the feeling of "pins and needles" or of a limb "falling asleep"...
when the biopsy is performed on a lymph node close to nerve
Nerve
A peripheral nerve, or simply nerve, is an enclosed, cable-like bundle of peripheral axons . A nerve provides a common pathway for the electrochemical nerve impulses that are transmitted along each of the axons. Nerves are found only in the peripheral nervous system...
s.
Test results
The test is used to help determine the cause of lymph node enlargement (swollen glands or lymphadenitis). It may also determine whether tumorTumor
A tumor or tumour is commonly used as a synonym for a neoplasm that appears enlarged in size. Tumor is not synonymous with cancer...
s in the lymph node are cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
ous or noncancerous. Enlarged lymph nodes may be caused by a number of conditions, ranging from very mild infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
s to serious malignancies
Malignant
Malignancy is the tendency of a medical condition, especially tumors, to become progressively worse and to potentially result in death. Malignancy in cancers is characterized by anaplasia, invasiveness, and metastasis...
. Benign
Benign
A benign tumor is a tumor that lacks the ability to metastasize. Common examples of benign tumors include moles and uterine fibroids.The term "benign" implies a mild and nonprogressive disease. Indeed, many kinds of benign tumors are harmless to human health...
conditions can often be distinguished from cancerous and infectious processes by microscopic examination. The pathologist may also perform additional tests on the lymph node tissue to assist in making a diagnosis
Diagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...
.
Some of the conditions where abnormal values are obtained are:
- Hodgkin's lymphomaHodgkin's lymphomaHodgkin's lymphoma, previously known as Hodgkin's disease, is a type of lymphoma, which is a cancer originating from white blood cells called lymphocytes...
- Non-Hodgkin's lymphoma
- SarcoidosisSarcoidosisSarcoidosis , also called sarcoid, Besnier-Boeck disease or Besnier-Boeck-Schaumann disease, is a disease in which abnormal collections of chronic inflammatory cells form as nodules in multiple organs. The cause of sarcoidosis is unknown...
- tuberculous cervical lymphadenitisScrofulaTuberculous cervical lymphadenitis refers to a lymphadenitis of the cervical lymph nodes associated with tuberculosis. It was previously known as "scrofula".-The disease:...
(scrofula)