Lymph Node Biopsy

Fast Facts

Day-stay surgery, then 2-7 days off work to recover.

Treatment of lymph node diseases is mainly non-surgical, under the supervision of your physician, haematologist or oncologist.

Surgery is to get a sample to make the diagnosis.

Surgery can cause temporary weakness in the face, tongue, shoulder and voice. Permanent weakness is rare

What is this for? Is it effective?

Lymph nodes are the size of a small bean. There are many lymph nodes throughout the body. They are made up of white cells. These are the cells of the immune system that fight infections and help healing after injury. Lymph nodes enlarge during infections. They can also enlarge due to tumours, chronic infections of auto-immune disease.

Taking a sample of a lymph node can help to diagnose these diseases. Your physician refers you to a surgeon to help with the diagnosis. Removing the lymph node doesn’t cure the disease. Most diseases of lymph nodes are treated with medicine by a haematologist, physician or oncologist.

Frequently Asked Questions

What could go wrong? Is there a chance that surgery could make me worse?

Temporary side effects:

1:100 people have a temporary side effect like wound infection or bleeding. These may require antibiotics or occasionally another operation to drain the infection or blood.

6:100 people have temporary nerve damage. Lymph nodes in the neck are usually close to nerves that make the face, tongue, voice and shoulder muscles work. If these nerves are damaged, you may have weakness in movement of one corner of the mouth, one side of the tongue or one shoulder. You may have weakness or hoarseness of the voice or a change in the appearance of the pupil. Temporary damage can last for up to 6 months. A nerve monitor is used during surgery to minimise the risk of damage to nerves.

Permanent side effects:

Less than 1:100 people have permanent damage to one of the nerves in the neck.

Could I need more surgery or treatment in the future?

Occasionally, the pathologist can’t make a diagnosis from the lymph node sample. You may need to have another procedure to get more sample to help with diagnosis.

Further non-surgical treatment will depend on the diagnosis. Your physician, oncologist or haematologist will explain your treatment options. For more information about cancer of the lymph nodes see the Leukaemia Foundation website.

Rarely, the scar is unattractive and another procedure is required to get a better cosmetic result.

What are the alternatives to surgery? Are they appropriate for me?

An ultrasound and FNA is usually done first. If a diagnosis can’t be made with an FNA, a surgical biopsy is needed.

What if I choose not to have surgery?

For mild disease, it may be ok not to have surgery. For possible cancer, surgery to make the diagnosis is recommended.

See should I have surgery for more information.

How should I prepare for surgery?

Stop using any supplements and medications that increase bleeding (like Nurofen) one week before surgery and follow the fasting instructions provided by the hospital. Stop smoking for as long as possible before surgery.

See preparing for surgery for more information.

When will I come into hospital? How long will the operation take? How long will I stay in hospital?

You will come into hospital on the day of surgery. The operation takes 30-60 minutes. Most people go home the same day.

How long will I need off work/school/sport?

You need 24 hours off driving after a general anaesthetic. You will need 2-7 days off work/school/sport, depending on the size and location of the lymph node.

Will I be awake or asleep for the operation? What kind of anaesthetic will I have?

Children and most adults have a general anaesthetic for this procedure. If you are very unwell or if the surgeon advises the procedure will be minor, you may have surgery with local anaesthetic and sedation. For more information see anaesthesia.

How will I feel after surgery?

You will have mild pain in the throat and in the wound. Most people need paracetamol only a few times in the first day after surgery.

1:30 people feel sick or vomit after surgery.

What do I need to do to recover well?

Keep the wound dry and the dressing intact for a week. Don’t rub or apply heat packs. Eat as well as possible to aid healing. Avoid smoking.

When will I see the surgeon?

The surgeon will check on you in the recovery room and in the office one week after surgery.

What should I do if I need help or advice?

You can ring the surgeon or practice nurse during business hours on 55605411. For advice outside business hours, ring the nurse at the hospital where you had surgery. For urgent care outside business hours, attend your nearest emergency department.

Click here for information about Dr Clancy’s on call schedule.

Is there any more information specific to my situation?

Your surgeon will take into consideration your work, sports/hobbies, support at home and other health problems as well as past reactions or complications with anaesthesia and surgery.

Your surgeon will answer any specific questions you ask.

After Lymph Node Biopsy

How long do I need off work, school and sport?

You need 24 hours off driving after a general anaesthetic. You shouldn’t drive on any day when you have taken strong pain relievers. The surgeon will let you know how long to take off work, depending on how extensive the surgery was. You may need between 2 and 7 days off work, sport and study to recover.

What do I need to do to recover well?

The better you eat, the better you heal, especially fruit and vegetables. Keep the wound dry and the dressing intact until you see the surgeon in one week. Avoid vigorous activity (running, gym, competitive sports) and aim for some exercise like walking on most days.

What is normal? How will I feel after surgery?

The wound will be mildly painful. There will be numbness around the wound.

What is not normal?

Contact your surgeon or attend your nearest emergency department if you have:

weakness in the face, tongue, voice or shoulder muscles,
increasing swelling under the wound,
vomiting lasting more than a few hours,
severe pain not controlled by the prescribed pain medication,
fever >38 degrees for more than 24 hours.