Lymph node biopsy

1. LYMPH NODE BIOPSY
DR GANESH KHARKATE
SENIOR RESIDENT
DEPT OF GENERAL
SURGERY
AIIMS NAGPUR

2. WHAT ARE Lymph Nodes
• Lymph nodes are small glandular structures in
the course of lymphatic vessels.
1]Dense connective tissue is the outermost
cover.
2]Cortex is composed of Primary and secondary
lymph follicles.

3. Functions of Lymph nodes
• Filtration of Lymph –Absorption of water and
electrolytes.
• Bacteria and other toxic substances are
destroyed by Macrophages of Lymph nodes

4. • Lymph nodes are found throughout the body.
• Part of the body’s immune system.
• These nodes help fight infection by producing
special white blood cells.
• They also work by trapping bacteria, viruses,
and cancer cells.
• Normally, lymph nodes cannot be felt unless
they are swollen.

5. Enlargement of lymph nodes:
• INFLAMMATORY : Acute and chronic lymphadinitis.
• Chronic is again subdivided into specific i.e TB, Syphlis,Filarial,
lymphpgranuloma inguinale. & Non specific or pyogenic.
• NEOPLASTIC: Almost always malignant. Primary and Secondary
Primary[reticulosis]: Hodgkin’s disease, Lymphosarcoma,
Reticulosarcoma, lymphtic leukaemia.
Secondary: Carcinoma, Melanoma, Sarcoma

6. DIFFERENT TYPES OF LYMPH NODE
BIOPSY
• Sentinel lymph node biopsy
• Fine needle aspiration (FNA).
• Core needle biopsy.
• Open biopsy.

7. Fine needle aspiration (FNA).

8. FNAC
• Needle into the lymph nodes to remove
fluid and cells, which get examined .
• local anesthesia is needed sometimes.
• 23 GAUGE NEEDLE IS REQUIRED
• Can be USG OR CT GUIDED(radiologist help
may be required )

9. Open or excisional biopsy
• The skin over the enlarged lymph node is
marked and cleaned.
• A cut called an incision is made through the
skin. If possible, the incision is made within
the creases of the neck.
• The enlarged lymph node is removed. It is sent
to a lab for testing.
• The incision is closed with stitches.

10. excisional biopsy

11. Core needle biopsy

12. Core needle biopsy devices

13. Types of core needles

15. • Regions for Procedure
• Common areas for biopsy include:
• Groin
• Armpit
• Neck
• Under the jaw and chin
• Behind the ears

16. Possible Complications of lymph node
biopsy
• Problems from the procedure are rare, but all
procedures have some risk. Your doctor will
review potential problems, like:
• Bleeding
• Infection
• Swelling
• Nerve damage, including numbness at the
biopsy site, which usually resolves in a few
months

17. Sentinel lymph node

18. Sentinal lymph node biopsy

19. Sentinal lymph node

20. Sentinal lymph node
• ISOPHANE BLUE
• METHYLENE BLUE
• 99mTc
• 99mTc-labelled colloidal
rhenium sulphide),
gamma probe and
gamma camera for
radiolocalisation and
monitoring

21. Sentinal lymph node
• MINIMUM 2 LN TO BE
TAKEN FOR BREAST
• MINIMUM 4 LN TO BE
TAKEN FOR AXILLARY
SAMPLING