Head & Neck
The lymph nodes are organised aggregations of lymphatic cells that are part of the lymphatic system found throughout the body. You can think of the lymph nodes as filters that detect infective agents (e.g. viruses and bacteria) as well as abnormal cells from various parts of the body (including cancer cells).
Lymph nodes may become larger for the following reasons:
- Reaction to infection (a.k.a reactive lymph node)
- Chronic inflammatory disorder including autoimmune diseases
- Cancer cells that have spread to the lymph node
- Malignant change in the lymphatic cells i.e lymphoma
A lymph node biopsy involves the removal of part or all of a lymph node which is then sent to the laboratory for detailed examination under microscopy and other specialised testing. This is known as histopathological diagnosis.
In some instances, a lymph node biopsy can be performed under local anaesthesia e.g a small isolated lymph towards the back of the side of the neck. The area in and around the lymph node can be made painless by injection of a local anaesthetic agent. You can be awake during the procedure, thus avoiding the possible side effects of general anaesthesia.
In all other instances and children in particular, the surgery is performed under general anaesthesia.
The usual approach to the parotid gland is an incision in a skin crease over the location of the lymph node. The lymph node is then carefully dissected, taking care to identify and preserve vital structures that are located in and around the gland e.g. nerves and larger blood vessels. Once the biopsy is complete, the incision is closed with fine sutures to minimise the cosmetic impact.