Ultrasound-guided lymph node biopsy

What is a lymph node biopsy?

Lymph nodes are small glands that produce white blood cells which fight infection.

A needle is inserted into your lymph nodes through the skin and a sample of lymph node tissue is removed. The sample is then sent to the laboratory for examination and is used to help your doctor treat you.

Benefits and risks

It will help your team investigate your symptoms and decide on the best treatment for you. It is a safe and short procedure which means you only need to remain in hospital for a day.

Sometimes there is small amount of bleeding from the biopsy site—that soon stops. Occasionally the bleeding is more severe, and rarely a blood transfusion or a further procedure will be required to help you. There is a small risk that the needle site will become infected after the biopsy.

We will discuss all of the risks and benefits with you in detail before your procedure.

Before you come in

Let your doctor know at least a week before your procedure if you take warfarin, aspirin or clopidogrel (tablets to thin the blood).

You are required to have a blood test to check how well your blood will clot. This is to make sure that you are not likely to bleed following the biopsy. Your biopsy cannot be done if your blood has not been taken.

You will find the instructions on how to do this in your appointment letter. 

Please arrange to have an escort home after your procedure and a friend or family member (this must be a responsible adult) to stay with you until the following day. This is very important otherwise you may not be able to have your liver biopsy.

On your appointment day

Please do not eat or drink. Take all your medications as usual (except aspirin, Clopidogrel or warfarin).

Arrive on the ward at 8am. Your appointment letter will advise you to go to Kobler Day Care or Medical Day Unit.

If you are late, it may not be possible to do your procedure and you will have to make another appointment.

Before the procedure

On the ward your nurse and doctor will ask you several questions about your health and current medication.

They will check your blood pressure and pulse and ask you to change into a gown.

Your nurse will escort you to the X-ray Department on your bed.

During the procedure

In the procedure room you will be seen by doctor—this is an opportunity to discuss the procedure before signing a consent form. Please ask any questions you may have, as it is important that you understand what is going to happen.

The doctor will use an ultrasound guide to decide on the best location to insert the biopsy needle. The puncture site will be cleaned with cleaning fluid and covered with a sterile sheet. 

Local anaesthetic will be injected which will cause some stinging initially and then go numb. Your pulse and blood pressure will be monitored. The biopsy needle will be inserted through your skin and a sample will be collected. A small dressing will be placed over the needle site. The procedure takes about 30 minutes to complete, but may take longer.

After the procedure

You will go back to the ward to recover for at least 3 hours. You may feel some discomfort around the biopsy site and pain in your right shoulder which can be treated with pain relieving tablets.

Going home

Once your nurse is happy that you have recovered completely from your biopsy, you will be discharged from hospital and your friend/ family member can take you home.

At home

• Rest at home for the remainder of the day and the following day.
• The waterproof dressing may remain on for 3–4 days. Take showers instead of baths to help the puncture site heal.
• Avoid excessive activity or lifting anything greater than 5 kg (11lb) for the next 5–7 days. If your job involves heavy manual work you are advised to take the week off.

Please contact your GP or A&E (after hours) if you experience pain at the needle site or have experienced any other adverse effects.

Contact information

Interventional Radiology Department
Chelsea and Westminster Hospital
369 Fulham Road
London
SW10 9NH
T: 020 3315 8570/8582

If you need to change your appointment time or date, please contact the Imaging Department on the numbers above as soon as possible.