Lymph node biopsy

Lymph node biopsy

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

14. Regions for Procedure Common areas for biopsy include: Groin Armpit Neck Under the jaw and chin Behind the ears

15. 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

16. Sentinel lymph node

17. Sentinal lymph node biopsy

18. Sentinal lymph node

19. Sentinal lymph node ISOPHANE BLUE METHYLENE BLUE 99m Tc 99m Tc-labelled colloidal rhenium sulphide ), gamma probe and gamma camera for radiolocalisation and monitoring

20. Sentinal lymph node MINIMUM 2 LN TO BE TAKEN FOR BREAST MINIMUM 4 LN TO BE TAKEN FOR AXILLARY SAMPLING