Lymph node biopsy: Difference between revisions

Lymph node biopsy
Lymph node biopsy
ICD-9-CM	40.11
MedlinePlus	003933
LOINC	66112-4

Browse history interactively

← Previous edit

Content deleted Content added

VisualWikitext

Inline

Latest revision as of 16:36, 5 January 2024

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 vessels. The nodes produce white blood cells (lymphocytes) that fight infections. 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.^{[citation needed]}

Imaging studies include CXR, CT scans of Abdomen,chest, pelvis, neck and PET scans.^{[citation needed]}

CBC, ESR, serum ferritin, bone marrow aspiration.

Indications

The test is used to help determine the cause of lymph node enlargement (swollen glands or lymphadenitis). It may also determine whether tumors in the lymph node are cancerous or noncancerous. Enlarged lymph nodes may be caused by a number of conditions, ranging from very mild infections 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.^{[citation needed]}

Some of the conditions where abnormal values are obtained are:^{[citation needed]}

Hodgkin's lymphoma
Non-Hodgkin's lymphoma
Sarcoidosis
tuberculous cervical lymphadenitis (scrofula)

Lymph node biopsies may be performed to evaluate the spread of cancer. See Lymphadenectomy#With sentinel node biopsy.

However, Sentinel lymph node biopsy for evaluating early, thin melanoma has not been shown to improve survival, and for this reason, should not be performed.^[1] Patients with melanoma in situ, T1a melanoma or T1b melanoma ≤ 0.5mm have a low risk of cancer spreading to lymph nodes and high 5-year survival rates, so this kind of biopsy is unnecessary.^[1]

Procedure

The test is done in an operating room in a hospital, or at an outpatient surgical facility. There are two ways the sample may be obtained:^{[citation needed]}

Needle biopsy
Open (excisional) biopsy

Needle biopsy

A needle biopsy involves inserting a needle into a node to obtain the sample.^{[citation needed]}

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.

Open biopsy

An open biopsy consists of surgically removing all or part of a node.^{[citation needed]}

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 bandaged.^{[citation needed]}

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 nerves.

References

^ ^a ^b
American Academy of Dermatology (February 2013), "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation, American Academy of Dermatology, retrieved 5 December 2013, which cites
- Bichakjian, C. K.; Halpern, A. C.; Johnson, T. M.; Foote Hood, A.; Grichnik, J. M.; Swetter, S. M.; Tsao, H.; Barbosa, V. H.; Chuang, T. Y.; Duvic, M.; Ho, V. C.; Sober, A. J.; Beutner, K. R.; Bhushan, R.; Smith Begolka, W.; American Academy Of, D. (2011). "Guidelines of care for the management of primary cutaneous melanoma". Journal of the American Academy of Dermatology. 65 (5): 1032–1047. doi:10.1016/j.jaad.2011.04.031. hdl:20.500.12749/1682. PMID 21868127.
- American Joint Committee on Cancer (2010). Stephen B. Edge (ed.). AJCC cancer staging manual (7th ed.). New York: Springer. ISBN 978-0-387-88440-0.
- National Comprehensive Cancer Network (2012), National Comprehensive Cancer Network clinical practice guidelines in oncology (NCCN Guidelines): melanoma (PDF), Fort Washington, Pennsylvania: National Comprehensive Cancer Network, archived from the original (PDF) on 28 December 2013, retrieved 5 December 2013

External links

Cancer Management Handbook: Lymph node biopsy

[AADfive-1] American Academy of Dermatology (February 2013), "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation, American Academy of Dermatology, retrieved 5 December 2013, which cites
Bichakjian, C. K.; Halpern, A. C.; Johnson, T. M.; Foote Hood, A.; Grichnik, J. M.; Swetter, S. M.; Tsao, H.; Barbosa, V. H.; Chuang, T. Y.; Duvic, M.; Ho, V. C.; Sober, A. J.; Beutner, K. R.; Bhushan, R.; Smith Begolka, W.; American Academy Of, D. (2011). "Guidelines of care for the management of primary cutaneous melanoma". Journal of the American Academy of Dermatology. 65 (5): 1032–1047. doi:10.1016/j.jaad.2011.04.031. hdl:20.500.12749/1682. PMID 21868127.

American Joint Committee on Cancer (2010). Stephen B. Edge (ed.). AJCC cancer staging manual (7th ed.). New York: Springer. ISBN 978-0-387-88440-0.

National Comprehensive Cancer Network (2012), National Comprehensive Cancer Network clinical practice guidelines in oncology (NCCN Guidelines): melanoma (PDF), Fort Washington, Pennsylvania: National Comprehensive Cancer Network, archived from the original (PDF) on 28 December 2013, retrieved 5 December 2013

[2] Bichakjian, C. K.; Halpern, A. C.; Johnson, T. M.; Foote Hood, A.; Grichnik, J. M.; Swetter, S. M.; Tsao, H.; Barbosa, V. H.; Chuang, T. Y.; Duvic, M.; Ho, V. C.; Sober, A. J.; Beutner, K. R.; Bhushan, R.; Smith Begolka, W.; American Academy Of, D. (2011). "Guidelines of care for the management of primary cutaneous melanoma". Journal of the American Academy of Dermatology. 65 (5): 1032–1047. doi:10.1016/j.jaad.2011.04.031. hdl:20.500.12749/1682. PMID 21868127.

[3] American Joint Committee on Cancer (2010). Stephen B. Edge (ed.). AJCC cancer staging manual (7th ed.). New York: Springer. ISBN 978-0-387-88440-0.

[4] National Comprehensive Cancer Network (2012), National Comprehensive Cancer Network clinical practice guidelines in oncology (NCCN Guidelines): melanoma (PDF), Fort Washington, Pennsylvania: National Comprehensive Cancer Network, archived from the original (PDF) on 28 December 2013, retrieved 5 December 2013

[1]

@@ Line 1: / Line 1: @@
+{{Infobox diagnostic |
-{{Diagnostic infobox |
-  Name        = {{PAGENAME}} |
+  Name        = Lymph node biopsy |
   Image       = |
   Caption     = |
@@ Line 6: / Line 6: @@
   ICD9        = {{ICD9proc|40.11}} |
   MeshID      = |
+  MedlinePlus = 003933 |
   OPS301      = |
   OtherCodes  = |
+  LOINC       = {{LOINC|66112-4}} |
 }}
 '''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.
+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.{{cn|date=February 2022}}
+Imaging studies include CXR, CT scans of Abdomen,chest, pelvis, neck and PET scans.{{cn|date=February 2022}}
-==How the test is performed==
-The test is done in an [[operating room]] in a [[hospital]], or at an outpatient [[outpatient surgery|surgical facility]]. There are two ways the sample may be obtained:
+CBC, ESR, serum ferritin, bone marrow aspiration.
+==Indications==
+The test is used to help determine the cause of lymph node enlargement (swollen glands or [[lymphadenitis]]). It may also determine whether [[tumor]]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 [[malignant|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]].{{citation needed|date=September 2018}}
+Some of the conditions where abnormal values are obtained are:{{cn|date=February 2022}}
+* [[Hodgkin's lymphoma]]
+* [[Non-Hodgkin's lymphoma]]
+* [[Sarcoidosis]]
+* [[scrofula|tuberculous cervical lymphadenitis]] (scrofula)
+Lymph node biopsies may be performed to evaluate the spread of cancer. See [[Lymphadenectomy#With sentinel node biopsy]].
+However, [[Sentinel lymph node biopsy]] for evaluating early, thin [[melanoma]] has not been shown to improve survival, and for this reason, should not be performed.<ref name="AADfive">{{Citation|author1=American Academy of Dermatology |author1-link=American Academy of Dermatology |date=February 2013 |title=Five Things Physicians and Patients Should Question |publisher=[[American Academy of Dermatology]] |work=[[Choosing Wisely]]: an initiative of the [[ABIM Foundation]] |url=http://www.choosingwisely.org/doctor-patient-lists/american-academy-of-dermatology/ |access-date=5 December 2013 }}, which cites
+* {{Cite journal
+| last1 = Bichakjian | first1 = C. K.
+| last2 = Halpern | first2 = A. C.
+| last3 = Johnson | first3 = T. M.
+| last4 = Foote Hood | first4 = A.
+| last5 = Grichnik | first5 = J. M.
+| last6 = Swetter | first6 = S. M.
+| last7 = Tsao | first7 = H.
+| last8 = Barbosa | first8 = V. H.
+| last9 = Chuang | first9 = T. Y.
+| last10 = Duvic | first10 = M.
+| last11 = Ho | first11 = V. C.
+| last12 = Sober | first12 = A. J.
+| last13 = Beutner | first13 = K. R.
+| last14 = Bhushan | first14 = R.
+| last15 = Smith Begolka | first15 = W.
+| last16 = American Academy Of | first16 = D.
+| title = Guidelines of care for the management of primary cutaneous melanoma
+| doi = 10.1016/j.jaad.2011.04.031
+| journal = Journal of the American Academy of Dermatology
+| volume = 65 | issue = 5 | pages = 1032–1047 | year = 2011
+| pmid = 21868127
+| doi-access = free
+| hdl = 20.500.12749/1682
+| hdl-access = free
+}}
+* {{cite book|title=AJCC cancer staging manual|year=2010|publisher=Springer|location=New York|isbn=978-0-387-88440-0|author=American Joint Committee on Cancer|edition=7th|editor=Stephen B. Edge}}
+* {{Citation|author=National Comprehensive Cancer Network |year=2012 |title=National Comprehensive Cancer Network clinical practice guidelines in oncology (NCCN Guidelines): melanoma |publisher=National Comprehensive Cancer Network |location=[[Fort Washington, Pennsylvania]] |url=https://subscriptions.nccn.org/gl_login.aspx?ReturnURL=http://www.nccn.org/professionals/physician_gls/pdf/melanoma.pdf |access-date=5 December 2013 |url-status=dead |archive-url=https://web.archive.org/web/20131228154542/https://subscriptions.nccn.org/gl_login.aspx?ReturnURL=https%3A%2F%2Frp.liu233w.com%3A443%2Fhttp%2Fwww.nccn.org%2Fprofessionals%2Fphysician_gls%2FPDF%2Fmelanoma.pdf |archive-date=28 December 2013 }}{{closed access}}</ref> Patients with melanoma in situ, T1a melanoma or T1b melanoma ≤ 0.5mm have a low risk of cancer spreading to lymph nodes and high 5-year survival rates, so this kind of biopsy is unnecessary.<ref name="AADfive"/>
+==Procedure==
+The test is done in an [[operating room]] in a [[hospital]], or at an outpatient [[outpatient surgery|surgical facility]]. There are two ways the sample may be obtained:{{cn|date=February 2022}}
 * [[Needle biopsy]]
 * Open ([[:wikt:excision|excisional]]) biopsy
 ===Needle biopsy===
-A needle biopsy involves inserting a needle into a node to obtain the sample.
+A needle biopsy involves inserting a needle into a node to obtain the sample.{{cn|date=February 2022}}
-The patient lies on the examination table; the biopsy site is cleansed; and a local [[anesthetic]] is injected. The [[Needle aspiration biopsy|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; the biopsy site is cleansed; and a [[local anesthetic]] is injected. The [[Needle aspiration biopsy|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.
 ===Open biopsy===
-An open biopsy consists of surgically removing all or part of a node.
+An open biopsy consists of surgically removing all or part of a node.{{cn|date=February 2022}}
-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 [[surgical suture|stitches]] and [[bandage]]d.
+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 [[surgical suture|stitches]] and [[bandage]]d.{{cn|date=February 2022}}
 The sample is then sent to [[pathology]].
@@ Line 33: / Line 79: @@
 With this test there is a small chance of [[infection]] or [[bleeding]]. Additionally, there is a moderate risk of [[nerve]] injury, localized [[paralysis]], or [[Paresthesia|numbness]] when the biopsy is performed on a lymph node close to [[nerve]]s.
-==Test results==
+==References==
+{{reflist}}
-The test is used to help determine the cause of lymph node enlargement (swollen glands or [[lymphadenitis]]). It may also determine whether [[tumor]]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 [[malignant|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:
-* [[Hodgkin's lymphoma]]
-* [[Non-Hodgkin's lymphoma]]
-* [[Sarcoidosis]]
-* [[scrofula|tuberculous cervical lymphadenitis]] (scrofula)
 ==External links==
-*[http://www.cancernetwork.com/cancer-management-11/chapter01/article/10165/1399286 Cancer Management Handbook: Lymph node biopsy]
+* [http://www.cancernetwork.com/cancer-management-11/chapter01/article/10165/1399286 Cancer Management Handbook: Lymph node biopsy]
 {{Lymphatic organ procedures}}
 [[Category:Biopsy]]
 [[Category:Lymphatic organ surgery]]

v t e Procedures relating to the haematopoetic and lymphatic systems
Bone marrow	Stem cell transplantation Hematopoietic stem cell transplantation
Thymus	Removal Transplantation
Spleen	Removal Transplantation
Lymph nodes	Lymphadenectomy Neck dissection Retroperitoneal lymph node dissection Lymph node biopsy
Tonsils	see Template:Procedures on the mouth and pharynx
Imaging	Lymphogram