A core biopsy of a lymph node is a medical procedure used to obtain a small tissue sample from a suspicious lymph node. This diagnostic tool helps medical professionals evaluate the cause of enlarged or abnormal lymph nodes.
Understanding Core Lymph Node Biopsy
A core lymph node biopsy involves using a hollow needle to extract a small, intact piece of tissue from a lymph node. This method differs from a fine needle aspiration (FNA), which typically collects only cells and fluid. The larger tissue sample allows pathologists to examine the cellular structure and arrangement, providing a more comprehensive view of the tissue’s architecture.
This procedure is often performed when a swollen lymph node is detected through physical examination or imaging tests like ultrasound or CT scans. A core biopsy helps diagnose cancer, determine the type and grade of a tumor, and assess if cancer has spread from another part of the body. It is also used to identify infections, such as tuberculosis, or inflammatory conditions like sarcoidosis, when other causes for persistent swelling are not clear.
The Biopsy Procedure
Preparing for a core lymph node biopsy involves reviewing current medications with your healthcare provider, especially blood thinners, which may need adjustment. You might be asked to avoid eating or drinking for a few hours before the procedure, depending on the type of anesthesia planned. The procedure is generally performed in an outpatient setting, meaning you can go home the same day.
During the biopsy, the area around the lymph node will be numbed with a local anesthetic injection. You may feel a brief sting from the injection, followed by a sensation of pressure. For lymph nodes that are not easily felt, imaging guidance, such as ultrasound or CT scan, is used to precisely direct the biopsy needle. A small incision might be made to allow the needle to be inserted.
The radiologist or surgeon then inserts a specialized hollow needle into the lymph node to collect one or more small tissue samples. You might hear a clicking sound as the samples are taken. The entire process, from numbing to sample collection, typically takes about 15 to 30 minutes. After the samples are collected, pressure is applied to the site to minimize bleeding, and a bandage is placed over the area.
After the Biopsy
Following a core lymph node biopsy, it is common to experience mild pain, tenderness, and bruising at the biopsy site for a few days. Over-the-counter pain relievers can help manage discomfort. Applying an ice pack to the area can also help reduce swelling and mild pain.
Your healthcare provider will provide specific instructions for wound care, which may include keeping the area clean and dry. Avoiding strenuous activities or heavy lifting that could strain the biopsy site for a few days is usually recommended. While rare, potential complications can include significant bleeding, infection, or persistent numbness. Contact your doctor if you experience increased pain, warmth, redness, pus draining from the site, or a fever, as these could indicate an infection.
Interpreting the Biopsy Results
After the tissue samples are collected, they are sent to a pathology laboratory for examination by a specialized doctor called a pathologist. The pathologist examines the tissue under a microscope, looking at cell types, their arrangement, and any unusual features. Special stains and molecular tests, such as immunophenotyping, may be performed to identify specific markers that help determine if cells are cancerous, infectious, or inflammatory.
The timeframe for receiving biopsy results can vary, but they are typically available within a few days to a few weeks. Your referring physician will discuss the results with you in detail. The biopsy results will classify the findings as either benign (non-cancerous) or malignant (cancerous). These results are a fundamental piece of your diagnostic assessment, guiding your medical team in understanding your condition and planning the most appropriate treatment strategy.