Lymph node biopsy

Description:

The biopsy of lymph nodes in a lymphology is made during diagnosis of a lymphostasis and a limfedema. The research is carried out to define a disease origin. The biopsy gives the chance to reveal fibrosis of inguinal lymph nodes (at primary limfedema), the inflammation of lymph nodes caused by a bacterial, parasitic, fungal or viral infection and distribution of malignant process at oncological diseases. A contraindication to carrying out a biopsy is serious condition of the patient, the systemic acute infection and the centers of a local infection on skin in the field of a material intake.
Lymph nodes are the peripheral bodies of lymphatic system which are carrying out a role of bacteria beds. The lymph inflowing from parts of a body and bodies brings alien antigens to nodes that causes formation of immune cellular and humoral responses.
The lymphadenopathy can be connected with increase in quantity of macrophages and lymphocytes when forming an immune response; inflammatory infiltration at lymphadenitis; proliferation of malignant macrophages and lymphocytes of in situ; infiltration of lymph nodes the malignant metastatic cells or macrophages containing a large number of metabolites at diseases of lipidic accumulation.
The biopsy of a lymph node is small surgical intervention during which a part or all changed node for the subsequent immunohistochemical, molecular or other studying is removed.
As options of a research of a lymph node serve closed (aspiration fine-needle and puncture) or opened (ekstsizionny or intsizionny) types of a biopsy. The biopsy of not palpated lymph nodes can be carried out under targeting of ultrasound or X-ray television.
Indications to a biopsy are specified during a palpation, performance of ultrasonography of lymph nodes, a X-ray analysis, KT, a stsintigrafiya.

Indications to a lymph node biopsy:

The biopsy of lymph nodes is carried out for definition of character of a lymphadenopathy if its reason does not manage to be established at noninvasive clinical inspection.
Need for a biopsy of a lymph node arises at long a current of a lymphadenopathy against the background of therapy of a basic disease or at discrepancy of a clinical pathomorphism to a condition of lymph nodes.
The obligatory biopsy of lymph nodes is carried out in case of identification of the clinical signs indicating the tumoral reason of a lymphadenopathy owing to limfoproliferativny (a lymphogranulomatosis, a lymphoma) or metastatic damage of lymph nodes.
In other cases of unambiguous indications to performance of a biopsy there are no lymph nodes. Some clinical physicians use the rule "1+1", carrying out a biopsy of the lymph node having the size> 1 cm and not decreasing within one month.
If at the patient at primary survey sharply increased, dense painless lymph nodes and symptoms of intoxication come to light, then the decision on need of a biopsy of lymph nodes is made at once.

Types of a biopsy of a lymph node:

The value of an aspiration fine-needle biopsy of a lymph node is limited to a possibility of microbiological and cytologic diagnosis at infectious and metastatic processes. After layer-by-layer infiltration of soft tissues anesthetic into a lymph node enters the needle of sufficient length with a diameter up to 2 mm attached to the syringe. After hit of a needle in a lymph node (that is controlled palpatorno or by means of ultrasonography) its contents are aspirated, applied on glass or collected in a test tube and sent to laboratory, having specified a research objective.
At a puncture biopsy of a lymph node receive a column of the fabrics allowing to investigate their histologic structure. The equipment of a puncture biopsy of a lymph node is similar to a fine-needle biopsy. The used aspirating needles with mandrin provide receiving and deduction of a piece of a lymph node. However at malignant process, according to the principles of an ablastika, the puncture biopsy of a lymph node can constitute danger of dissimination of tumor cells. Besides, the aspiration and puncture biopsy of a lymph node can be followed in a false manner by positive or false negative takes.
During an open biopsy the lymph node is removed partially or completely through a skin minisection. Technology of carrying out an open biopsy depends on localization of a lymph node. During a biopsy preference is given to the largest and modified lymph node. The advantage of this option of a biopsy is the possibility of direct vision of operation, receiving enough informative material for high-reliable histologic diagnosis.
The open biopsy of a lymph node can be also executed intraoperatsionno. In this case express diagnosis is carried out and at identification of malignant cells in lymph nodes the expanded option of operation is carried out.

Complications after a lymph node biopsy:

Various options of a biopsy of lymph nodes belong to interventions of small risk. However after carrying out a biopsy the infection, bleeding, damage of nerve or lymphatic pathways can sometimes develop.
At emergence of signs of local infection, fever, a fever, hypostasis, reddening, strengthening of pain, bloody or other allocations from a zone of a biopsy it is necessary to see a doctor.