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A lymph node is a component of the immune system that serves as a filter to protect the body against harmful substances. They can be found all over the body and in healthy people, they are not usually noticeable or palpable. An enlarged or swollen lymph node typically suggests the presence of a pathologic condition.
A lymph node biopsy is a procedure wherein an entire lymph node or a part of it is extracted and sent to the laboratory to diagnose certain conditions, grade cancer, or to determine if cancer has metastasised to other parts of the body.
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Lymph node biopsy is recommended for patients with:
Enlarged lymph nodes – Enlarged lymph nodes typically suggest the presence of an underlying disease, such as an infection or cancer. A biopsy is often recommended particularly if a myriad of other non-specific symptoms accompany lymph node enlargement, such as حمة, cough, generalised weakness, and weight loss.
Cancer – Lymph node biopsy plays a major role both in the diagnosis and staging of cancer, helping physicians determine the proper course of therapy for cancer patients. In cases of breast cancer, sentinel lymph node biopsy can be performed to determine if the disease has spread to the lymphatics.
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A lymph node biopsy is usually a minor surgical procedure performed on an outpatient basis. There are different techniques used for this procedure depending on the severity of the case and the part of the body where the lymph node is taken.
A needle خزعة is the simplest form and uses a syringe with a needle at the end to aspirate cells from the lymph node. This can be performed on both small and large nodes that lie in deep areas, such as the chest. In these cases, some form of imaging technology (such as a CT scan) may be needed as a guide for the physician performing the procedure. The sample is then fixed on a glass slide for review under a microscope.
Compared to a needle biopsy, which only takes samples of a lymph node, an open biopsy involves the removal of the entire lymph node. This technique is ideal for those that are in superficial locations, such as the neck. Because the node is usually accessible, the procedure is typically performed under local anesthesia. A small incision is made over the lymph node so it can be dissected from surrounding tissues and removed. The biopsy site is then closed with sutures and bandage is applied over the wound.
Sentinel lymph node biopsy, on the other hand, is a specialised kind of lymph node biopsy performed in certain cancer patients. A dye or a radioactive tracer is injected into the cancer site to determine and remove the lymph nodes that is closest to the cancer. The node is then sent to a laboratory for further examination.
For patients undergoing surgery for a malignancy, such as lung cancer, lymph nodes near the tumor may also be excised and sent for biopsy to determine the stage of cancer and subsequent treatment (for example, chemotherapy or radiotherapy).
Various kinds of examinations can be performed for the harvested lymph nodes, which are fixed and examined under a microscope to check for specific histopathologic features. For undetermined malignancies, certain immunohistochemical studies can be performed to diagnose the specific type of cancer the patient has. Other studies, such as immunophenotyping and in situ hybridization tests, may also be performed to distinguish cancer subtypes, such as in the case of lymphoma.
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Minimal risks are associated with lymph node biopsies. Slight swelling and pain around the biopsy site are normal and usually resolve on their own after a few days. Bleeding is another risk, especially if the lymph nodes are located near blood vessels. When performed properly, a lymph node biopsy will result only in minimal bleeding that stops spontaneously after pressure is applied. Numbness may also occur, especially if the lymph nodes lie close to a nerve but sensation usually returns after several weeks. Infection is another risk but is not commonly encountered. Regular dressing and antibiotic treatment are used to manage these infections.
Burstein HJ, et al. (2011). Malignant tumors of the breast. In VT DeVita Jr et al., eds., DeVita, Hellman and Rosenberg’s Cancer: Principles and Practice of Oncology, 9th ed., vol. 3, pp. 1401-1446. Philadelphia: Lippincott Williams and Wilkins.
Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.
Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
## What is Lymph Node Biopsy: Overview, Benefits, and Expected Results
Lymph node biopsy is a medical procedure to extract a lymph node or a portion of a lymph node for detailed examination, typically to assess the presence of infection, cancer, or other diseases. Lymph nodes are small, bean-shaped structures that are part of the body’s immune system and play a crucial role in filtering and combating infections. They are located throughout the body, with clusters found in certain areas such as the neck, armpits, and groin.
**Benefits of Lymph Node Biopsy**
Lymph node biopsy offers several benefits in diagnosing and treating various conditions:
* **Accurate Diagnosis:** It provides a definitive diagnosis for various diseases, including lymphoma, leukemia, and metastatic cancer. Examining the lymph node tissue allows pathologists to determine the type of cells involved and the extent of the disease.
* **Staging of Cancer:** Lymph node biopsy helps stage cancer by assessing the spread of cancerous cells to regional lymph nodes. Accurate staging is essential for determining the appropriate course of treatment and prognosis.
* **Evaluation of Infections:** Lymph node biopsy can help identify the cause of infections, such as bacterial or viral infections. Examining the lymph node tissue aids in isolating the causative microorganisms and guiding appropriate treatment.
* **Assessment of Immune Disorders:** Lymph node biopsy is valuable in evaluating immune system disorders. It helps detect abnormal cell populations, determine the type of immune disorder, and monitor treatment response.
* **Guidance for Treatment:** Results from lymph node biopsy inform treatment decisions for cancer and other diseases. The information gathered guides oncologists, hematologists, and other specialists in selecting the most effective treatment approach.
**Expected Results of Lymph Node Biopsy**
The expected results of a lymph node biopsy depend on the underlying condition being investigated:
* **In Cancer Diagnosis:** If cancer is detected, the results provide critical information about the type, stage, and extent of the disease. This information shapes the treatment plan and helps monitor the response to therapy.
* **In Staging Cancer:** Lymph node biopsy results aid in determining the stage of cancer. A tumor’s stage affects the choice of treatment and prognosis.
* **In Evaluating Infections:** Lymph node biopsy results help identify the responsible microorganisms, enabling targeted antimicrobial therapy and guiding treatment duration.
* **In Immune Disorder Assessment:** The results assist in characterizing immune disorders, directing appropriate treatment, and monitoring disease activity and treatment response.
Lymph node biopsy is a crucial procedure in the diagnosis and management of a range of diseases, including cancer, infections, and immune disorders. It provides valuable information for accurate diagnosis, staging of cancer, assessment of infections, and evaluation of immune disorders, guiding appropriate treatment decisions and monitoring disease progression and treatment outcomes.