Lymph node biopsy is a surgical procedure to remove and examine lymph nodes to determine if they contain cancerous cells or other abnormalities. There are different types of lymph node biopsies including fine needle aspiration, core needle biopsy, open biopsy, and sentinel lymph node biopsy. Complications can include bleeding, infection, swelling, or nerve damage, but are generally rare. The document discusses the anatomy and functions of lymph nodes, indications for biopsy such as inflammation or cancer, different biopsy procedures and techniques, and potential risks.

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