Cervical lymph node biopsy: When to do?

Neck lymphadenopathy can be caused by many causes, including metastatic cancer. Therefore, in some cases when cervical lymph nodes are detected but the diagnosis is not clear, a biopsy of the cervical lymph nodes can be used to make tissue to clarify the diagnosis.

The body has about 600 lymph nodes distributed everywhere. The lymph nodes play an important role in the immune system because the lymph nodes produce lymphocytes that detect and destroy pathogens in the body.
Defense mechanism of the lymph nodes: When there is an infection or cancer, the lymph nodes will have to produce a larger amount of lymphocytes than usual to perform the function of protecting the body of the lymph nodes, so the lymph nodes will enlarge. Normally, lymph nodes can be palpated under the jaw, axillary lymph nodes, and inguinal lymph nodes.

Common causes of cervical lymphadenopathy are infection, tuberculosis, and cancer. Includes pathology of the skin, soft tissues of the head and neck, oral cavity, pharynx, larynx, and ears.
2.1 Enlarged lymph nodes due to infection Found foci of infection on ENT examination, skin boils, sores in the oral cavity and tongue, pharyngitis, inflammation or abscesses of the gums. Characteristics of the lymph nodes: the diameter of the lymph nodes is usually small. On palpation, a well-motile lymph node is not adherent to surrounding tissue, has well-defined margins, and is moderately tender, not overly firm. The lymph nodes will disappear on their own or after the patient is treated with anti-inflammatory antibiotics.
2.2 Tuberculosis-associated cervical lymphadenopathy Characteristics of tuberculosis-associated lymph nodes: lymph nodes are usually painless, small, unequal in size appearing gradually, painless, and arranged in chains. Accompanied by fever in the afternoon, thin weight loss, ... There are tuberculosis lesions in other places such as lungs, pleura, peritoneum.
2.3 Lymphoma The lymph nodes are enlarged, solid density, poor mobility, lymph nodes can be isolated but sometimes fused together in clusters. There may be accompanying symptoms such as edema, pain around the lymph nodes due to nerve, blood vessel compression. Diagnosis is determined by biopsy of the lymph nodes showing cancer cells.

2.4 Metastatic cancer Metastatic cancer such as breast cancer, nasopharyngeal cancer, uterine cancer, penile cancer with inguinal lymph node metastasis, gastric cancer with cervical lymph node metastasis...diagnosed by lymph node biopsy metastatic cancer cells.
2.5 Neck lymphadenopathy in venereal disease Lymphoma in syphilis: In the early stages of disease, lymph nodes are enlarged near the site of entry of the spirochetes (inguinal). Usually 4-5 small nodes. Slightly solid, easy to move, painless. In stage II, lymph nodes can be found anywhere in the body and become larger.
2.6 Acute Leukemia The lymph nodes are enlarged, soft, and mobile, appearing mostly in lymph node regions (neck, axilla, supraclavicular fossa, groin). Prominent signs are rapid development of anemia syndrome, subcutaneous bleeding syndrome, very high fever, rapid spleen enlargement. There are ulcerative lesions of the oral and pharyngeal mucosa.
2.7 Chronic Lymphocytic Leukemia The lymph nodes are numerous, small, and rapidly growing. The spleen is only slightly enlarged, causing the blood and marrow histograms, red blood cells and platelets to decrease, and the lymphocyte flow to increase a lot.
2.8 Hodgkin's Lymphoma More common in men than women, enlarged in the left supraclavicular fossa, then spreading to the neck. The characteristics of the lymph nodes are firm, painless, non-adherent to the skin, non-sticky, and non-purulent. Often accompanied by symptoms of intermittent fever, each time the fever is enlarged, or another lymph node appears.

A lymph node biopsy is the removal of an entire or more lymph nodes and histopathological examination. Lymph node histopathology allows doctors to see the lymph node structure, morphology, and cell distribution in the lymph node.
Biopsy of the neck lymph nodes is indicated in the following cases:
Lymphoma is suspected, metastatic cancer in the lymph nodes is suspected, Tuberculosis of the neck lymph nodes, of unknown cause

Although the procedure is relatively safe, there are still complications and complications:
Bleeding, hematoma at the biopsy site: Bleeding can occur when dissecting lymph nodes located near or sticking to blood vessels, need to be careful. When conducting. Infection: If you have an infection that is swollen, red, painful, and worse, you should go to the hospital for examination and early treatment. Nerve damage : Care should be taken when performing dissection of the ganglia, avoiding the nerves. Biopsy is a rather complicated technique, so doctors will only do biopsies after easier diagnostic techniques have been performed (X-ray, ultrasound, laboratory tests) that are still uncertain. sure disease. According to experts, viewing tissue or cells under the microscope always gives the most accurate diagnostic results and is very effective when determining the nature of a tumor: benign or malignant. Once it is determined that the tumor is malignant, the doctor will order a biopsy of nearby tissues to see if the tumor has metastasized or not, so that appropriate therapy can be given to the patient. Because it is a difficult technique, to ensure safety and get the most accurate results, it is best to choose a large, reputable medical facility to perform. Currently, Vinmec International General Hospital is one of the leading prestigious hospitals in the country, trusted by a large number of patients for medical examination and treatment. Not only the physical system, modern equipment: 6 ultrasound rooms, 4 DR X-ray rooms (1 full-axis machine, 1 light machine, 1 general machine and 1 mammography machine) , 2 DR portable X-ray machines, 2 multi-row CT scanner rooms (1 128 rows and 1 16 arrays), 2 Magnetic resonance imaging rooms (1 3 Tesla and 1 1.5 Tesla), 1 room for 2 levels of interventional angiography and 1 room to measure bone mineral density.... Vinmec is also the place to gather a team of experienced doctors and nurses who will greatly assist in diagnosis and detection. early signs of abnormality in the patient's body. In particular, with the space designed according to 5-star hotel standards, Vinmec ensures to bring the patient the most comfort, friendliness and peace of mind.