Lymph Node Biopsy for Lymphoma: What to Expect and How to Understand Your Results

Before a lymph node biopsy, you may be wondering what to expect. In this article, you will learn what a lymph node biopsy is, how the lymph node biopsy procedure is done, how long it usually takes, and how to understand your results. 

What is a lymph node biopsy?

A lymph node biopsy is a procedure where a healthcare specialist removes all or part of a lymph node so it can be looked at under a microscope. Lymph nodes are small, bean-shaped organs that are part of your immune system. They filter a clear fluid called lymph that carries infection-fighting white blood cells. Cancer cells can also be found in lymph.

During a lymph node biopsy, the removed tissue is sent to a lab. A pathologist checks it for cancer cells, infection, or other problems. Pathologists are doctors who specialize in cells and tissues. 

A lymph node biopsy is important for diagnosing lymphoma. It can confirm if you have lymphoma, what type it is, and how best to plan your treatment. 

Why is a lymph node biopsy recommended?

Your care team may suggest a lymph node biopsy for lymphoma if you have:

• A lymph node that stays swollen for a long time
• Imaging tests that look suspicious for lymphoma
• Symptoms such as fevers, night sweats, or weight loss without a clear reason

A lymph node biopsy can also help your team see if cancer has spread from one area of your body into nearby lymph nodes. This information is important for “staging,” which means finding out how advanced the lymphoma is and which treatment options may be most helpful.

Who does a lymph node biopsy?

Different specialists may perform a lymph node biopsy, depending on where the lymph node is located and what type of biopsy is needed:

• A radiologist or interventional radiologist may use imaging and a needle to take a small sample
• A surgeon may remove a whole lymph node or a larger piece of tissue
• A pathologist examines the sample in the lab and writes the biopsy report 

Later, a hematologist (a doctor who treats blood and bone marrow conditions) and an oncologist (a doctor who treats cancer) use these results to guide your care. Knowing who is involved can help you understand each person’s role and who to ask specific questions.

Types of lymph node biopsies

There are several kinds of lymph node biopsies:

• Excisional biopsy: The surgeon removes the whole lymph node.
• Incisional biopsy: The surgeon removes a large part of a lymph node.
• Core needle biopsy: A larger needle removes a small cylinder of tissue.
• Fine-needle aspiration: A thin needle removes fluid and cells.
• Sentinel lymph node biopsy: The “sentinel” lymph node is the first node that cancer is likely to spread to. A dye or tracer is used to find and remove this node for testing. 

What happens during the lymph node biopsy?

Before the biopsy, your provider will review:

• Your medicines, including vitamins and supplements
• Any bleeding problems or allergies
• Whether you may be pregnant

They will explain if you need to stop eating or drinking for a time and whether you need someone to drive you home.

During the lymph node biopsy:

1. You lie on an exam table.
2. You receive anesthesia, which is medicine that prevents pain. Local anesthesia numbs one area of your body. General anesthesia puts you to sleep.
3. The provider uses their hands or imaging (such as an ultrasound or a CT scan) to find the lymph node. Sometimes a special dye helps highlight the node.
4. They remove all or part of the lymph node.
5. The area is closed with stitches and covered with a bandage.
6. You should not feel pain during the procedure. Some soreness afterward is common, and your provider can suggest safe over-the-counter pain relievers.

How long does a lymph node biopsy take?

A lymph node biopsy may be:

• About 10 to 30 minutes for a simple needle biopsy
• Up to about 45 minutes for an open biopsy with a larger cut

Most lymph node biopsies are outpatient, which means you go home the same day. Knowing the typical time frame can help you plan for transportation, time off work, or childcare.

Possible side effects of a lymph node biopsy and when to call your care team

Most people heal without major problems, but side effects can include:

• Mild pain, bruising, or swelling at the biopsy site
• A small amount of bleeding
• Temporary numbness near the area

Less common issues include infection, heavier bleeding, or lymphedema. Lymphedema is swelling caused by lymph fluid not draining well. It can cause lasting swelling in an arm or leg if many lymph nodes are removed, but it is rare after a small biopsy.

Call your care team if you notice:

• Fever or chills
• Worsening pain
• Redness, warmth, or unusual drainage from the biopsy site

Reporting symptoms early helps your team treat any problems quickly.

How to read lymph node biopsy results

Your biopsy report will say whether the sample is:

• Negative: No lymphoma or other cancer is found.
• Positive: Cancer cells are found in the lymph node.

If lymphoma is present, the pathologist will run special tests on the cells, such as:

• Looking for certain proteins on the cell surface called markers
• Checking for changes in the cell’s DNA, such as rearrangements or missing pieces

These details help your team learn the exact type of lymphoma (for example, Hodgkin or non-Hodgkin) and how it behaves. This information is important for choosing therapies such as chemotherapy, immunotherapy, radiation, or CAR T-cell therapy. Your hematologist or oncologist will review the report with you, explain what it means in plain language, and talk through your next steps.

Conclusion

A lymph node biopsy is a common and important test that helps confirm whether you have lymphoma and what type it is. Understanding how the lymph node biopsy for lymphoma works, how long it takes, and what your results mean can help you feel more prepared and more confident when talking with your care team about treatment decisions. 

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Sources:

• NIH | Anatomy, Lymph Nodes
• Lymphoma Diagnostic Tests | Types of Biopsies
• NIH | Non-Hodgkin Lymphoma
• NIH | Hodgkin Lymphoma
• NIH | Sentinel Lymph Node Biopsy
• Impact of Expert Pathologic Review of Lymphoma Diagnosis