What is Lymph Biopsy? Types, Applications, and Results

Lymph biopsy is a medical procedure where all or part of a lymph node is removed and examined under a microscope for diseases such as infection or cancer. Lymph biopsy, which has different types such as sentinel lymph node biopsy and needle biopsy, can be performed not only for cancer diagnosis and staging but also to understand the causes of unexplained lymph node swellings through other diagnostic methods.

What is Lymph Biopsy and When is it Applied?

Lymph node biopsy is a medical procedure where tissue samples are taken from lymph nodes using various techniques and examined under a microscope. Lymph nodes, which are important components of the lymphatic system, play a crucial role in many important processes, from maintaining fluid balance in tissues and organs to protecting the body against infectious diseases. Among their primary functions, lymph nodes can produce and store lymphocytes, which are vital cells of the immune system, to defend the body against serious health issues such as infectious diseases or cancer. As a result, swelling or enlargement of lymph nodes may be observed.

In patients presenting with complaints of swelling in the lymph nodes, doctors may first examine the lymph nodes using imaging methods such as ultrasound and computed tomography. However, determining the cause of swelling and enlargement in lymph nodes is not always easy. In this case, a lymph node biopsy may be decided upon. Accordingly, the main situations where lymph node biopsy can be performed are as follows:

• To definitively diagnose cancers such as lymphoma or to evaluate whether primary cancers like breast cancer have metastasized to the lymph nodes,
• To investigate the cause of persistent lymph node swelling.

Additionally, lymph node biopsy can also be performed to plan the treatment process for diseases such as cancer or to evaluate the response to treatment.

How is Lymph Biopsy Performed and What are its Types?

Lymph biopsy is a procedure where all or part of a lymph node is removed using various methods and examined in a laboratory environment. Depending on the area from which the tissue sample is taken, the biopsy procedure can be referred to as groin lymph biopsy, axillary lymph node biopsy, neck lymph biopsy, etc. The main types of lymph node biopsies are as follows:

• Fine Needle Aspiration Biopsy: During fine needle aspiration biopsy of the lymph node, specialists first numb the area from which the biopsy sample will be taken with local anesthesia. Then, a thin needle and syringe are used to reach the lymph node and obtain a tissue sample.
• Core Needle Biopsy: Also known as core needle biopsy, this procedure is similar to fine needle aspiration but uses a larger needle that allows for obtaining more tissue samples. Both types of lymph node needle biopsies are usually completed within 15-30 minutes. During the procedure, the needle may need to be inserted several times into the lymph node to obtain a sufficient amount of tissue sample.
• Sentinel Lymph Node Biopsy: Sentinel lymph node biopsy is performed to examine whether cancers such as breast cancer or skin cancer have spread to the lymph nodes. As cancer spreads from the primary site, it follows a specific order. Therefore, during the procedure, specialists first inject a contrast agent to determine which lymph nodes are likely to be affected first if the cancer spreads. Sentinel lymph node biopsy is usually performed under general anesthesia. Specialists identify the sentinel lymph nodes using the injected substances, make a small incision on the skin, and remove one or more lymph nodes. Various studies suggest that removing three sentinel lymph nodes may be sufficient to evaluate cancer. After removing the lymph nodes, the specialist sutures the incision and sends the samples to the laboratory for examination.
• Surgical Biopsy: In some cases, doctors may not be able to easily access the lymph nodes through the skin. In this case, they may make a small incision to remove part or all of the lymph node. Surgical lymph node biopsy, which can take a bit longer than needle biopsy, is usually completed within 30-45 minutes. It is normal to experience some pain after the procedure.

Regardless of the technique used for the lymph node biopsy procedure, the tissue samples obtained after the procedure are thoroughly evaluated by expert pathologists in the laboratory. This way, a definitive diagnosis of cancer can be made, its stage can be determined, and the cause of the swelling observed in the lymph node can be understood.

How Should Patients Prepare Before Lymph Biopsy?

The preparation process for lymph biopsy is important for the successful execution of the procedure and for preventing potential complications that may arise during and after the procedure. Before the biopsy, specialists carefully evaluate the patient’s medical history. It is important for doctors to be informed about blood clotting issues, medications used, and allergies. To minimize the risk of bleeding during and after the biopsy, patients using blood-thinning medications or herbal supplements may need to stop these medications or supplements a few days before the procedure, as advised by their doctors. Patients scheduled to undergo biopsy with general anesthesia should refrain from eating and drinking for a period before the procedure. Additionally, it is recommended that patients receiving general anesthesia have a companion with them.

What Complications May Occur During and After Lymph Biopsy?

Although lymph node biopsy is generally a safe procedure, as with any medical procedure, there is a risk of certain complications, especially if specialists’ recommendations are not followed. The main complications of lymph biopsy are as follows:

• In rare cases, infections may develop in the areas where the procedure is performed. Specialists may prescribe antibiotics to minimize the risk of infection after the procedure.
• The risk of bleeding is low during and after minimally invasive procedures such as fine needle aspiration. However, there may be some bleeding after biopsies performed with incisions. This risk may be higher in patients using blood-thinning medications. It is important to inform doctors if bleeding persists for a long time.
• Rarely, a nerve near the lymph nodes may be damaged during the biopsy. In this case, the person may experience numbness in the area where the procedure was performed. Normally, this numbness is expected to resolve within 1-2 months after the procedure. If it does not resolve, it is recommended to consult specialists.

In addition to the above, in rare cases, swelling known as lymphedema may occur due to the accumulation of lymph fluid in the area. This situation is more commonly seen after surgical biopsies where large lymph nodes are removed. Mild complications such as redness, bleeding, and bruising after lymph node biopsy are normal. However, if these persist for a long time and are accompanied by symptoms such as high fever or abnormal discharge from the biopsy site, it is important to consult a specialist doctor without delay.

How Long Does it Take to Get Lymph Biopsy Results and How are They Interpreted?

Lymph biopsy results are usually obtained within 1-2 weeks. The time it takes to receive results may vary depending on how detailed the biopsy sample is examined in the laboratory. By examining the sample taken from the lymph node under a microscope, it can be determined whether the person has a specific disease. For example, a positive indication in the report may indicate cancer. In this case, specialists may need to conduct further tests to determine whether the cancer originated from the lymph nodes or another organ.

Frequently Asked Questions

It is important to consult a specialist without delay if you notice swelling, pain, or persistent growth in the lymph nodes. Hisar Hospital’s specialist physicians are here to assist you with accurate diagnosis and effective treatment processes. For more information and to make an appointment, please contact us immediately here.