What is lymph node biopsy, how is it done?

Enlargement of lymph nodes located in the neck, axilla, inguinal region, and abdomen is very common in cancer or inflammatory conditions. Lymph nodes are places where cancer spread is common, and tumors belonging to the lymph nodes, such as lymphoma, are relatively common causes of lymph node enlargement. When enlargement and mass are seen in the lymph node, a lymph node biopsy is performed to distinguish whether the enlargement is due to inflammation or a lymph node tumor (lymphoma), or cancer that shows tumor spread (metastasis) to the lymph node.

While the ultrasound-guided biopsy is usually taken from superficial lymph nodes, a biopsy is taken under the guidance of computed tomography (CT) from lymph nodes located deep in the abdomen and adjacent to vital organs such as the aorta.

Fine-needle aspiration biopsy (FNAB) can reveal the presence of malignant cells, especially in cases who have undergone tumor operation in the head and neck region, when there is small-sized but suspicious lymph node enlargement. If FNAB is to be performed, there is no need for pre-procedure preparation.

Apart from this, especially the lymph nodes in the axilla in breast cancer, neck, intra-abdominal, etc. trucut biopsy from enlarged lymph nodes is preferred. Since even trucut biopsies may be insufficient for subtype determination in lymphoma, as many biopsy samples should be taken from as many different parts of the lymph node as possible. Bleeding and coagulation parameters such as hemogram, INR, APTT, and blood values are checked before a trucut biopsy is performed. The procedure can be performed with local anesthesia (for superficial lymph nodes) or, in addition to local anesthesia, intravenous pain reliever-sedative drugs are given (for deep-seated lymph nodes in the abdomen).

After the point of entry is determined, the needle, which allows a thinner needle to pass through what we call the coaxial needle, is placed into the lymph node under ultrasound or CT guidance, avoiding the vessels. After it is seen that we are inside the lymph node, the fine needle in the coaxial needle is removed and the appropriate automatic biopsy needle is inserted, and a piece of the tissue is obtained from different parts 4-5 times with this needle. The obtained materials are evaluated by the pathologist during the process and if sufficient material is obtained, the process is terminated; In centers where onside pathology specialists are not available, the material is prepared appropriately and sent to the pathology laboratory. Fine-needle aspiration biopsy (FNAB) can also be performed in cases where a trucut biopsy cannot be taken safely because it is small in size and very close to the vessels. Afterward, the automatic biopsy needle and then the coaxial needle are withdrawn, and the control ultrasound or CT is taken and bleeding etc. check if there is. The skin is cleaned in a sterile way and covered with small gauze we call a sponge. The patient is kept under observation for approximately 1-2 hours and then discharged after clinical and, if necessary, blood test or ultrasound control.
 

https://www.instagram.com/p/CNxG0G3L1e2/

https://www.instagram.com/p/CYY9HOcMAnR/