淋巴结活检

定义

A lymph node biopsy is the removal of lymph node tissue for examination under a microscope.

The lymph nodes are small glands that make white blood cells (lymphocytes), which fight infection. Lymph nodes may trap the germs that are causing an infection. 癌症可以扩散到淋巴结.

选择的名字

Biopsy - lymph nodes; Open lymph node biopsy; Fine needle aspiration biopsy; 前哨淋巴结活检

如何执行测试

A lymph node biopsy is often done in an operating room in a hospital or at an outpatient surgical center. 活检可以用不同的方法进行.

An open biopsy is surgery to remove all or part of the lymph node. This is usually done if there is a lymph node that can be felt on exam. This can be done with local anesthesia (numbing medicine) injected into the area, 或者全身麻醉. The procedure is typically done in the following way:

• 你躺在检查台上. You may be given medicine to calm you and make you sleepy or you may have general anesthesia, 也就是说你睡着了，没有疼痛吗.
• 清洗活检部位.
• 做一个小的手术切口. 淋巴结或部分淋巴结被切除.
• The incision is closed with stitches and a bandage or liquid adhesive is applied.
• 开放活检可能需要30到45分钟.

For some 癌症s, a special way of finding the best lymph node to biopsy is used. This is called sentinel lymph node biopsy, and it involves:

少量的示踪剂, either a radioactive tracer (radioisotope) or a blue dye or both, is injected at the tumor site or in the area of the tumor.

The tracer or dye flows into the nearest (local) node or nodes. 这些淋巴结被称为前哨淋巴结. The sentinel nodes are the first lymph nodes to which a 癌症 may spread.

切除前哨淋巴结.

Lymph node biopsies in the belly may be performed with a laparoscope. This is a small tube with a light and camera that is inserted through a small incision in the abdomen. One or more other incisions will be made and tools will be inserted to help remove the node. The lymph node is located and part or all of it is removed. 这通常在全身麻醉下进行, which means the person having this procedure will be asleep and pain-free.

After the sample is removed, it is sent to the laboratory for examination.

A needle biopsy involves inserting a needle into a lymph node. This type of biopsy can be performed by a radiologist with local anesthesia, 使用超声或CT扫描找到淋巴结. It can also be performed by a surgeon without imaging if the lymph node can be felt.

如何准备考试

告诉你的十大赌博平台排行榜:

• 如果你怀孕了
• 如果你有的话 药物过敏
• 如果你有出血问题
• What medicines you are taking (including any supplements or herbal remedies)

您的提供者可能会要求您:

• 停止服用任何血液稀释剂, 比如阿司匹林, 肝素钠, 华法林(香豆素), 或氯吡格雷(Plavix)
• Not eat or drink anything after a certain period of time before the biopsy
• 在一定的时间到达办理手续

考试的感觉如何

When the local anesthetic is injected, you will feel a prick and a mild stinging. The biopsy site will be sore for a few days after the test.

开放性或腹腔镜活检后, the pain is usually mild and you can easily control it with an over-the-counter pain medicine. You may also notice some bruising or fluid leaking for a few days. 按照说明处理切口. 在伤口愈合的时候, avoid any type of intense exercise or heavy lifting that causes pain or discomfort. Ask your provider for specific instructions about what activities you can do.

为什么要进行测试

The test is used to diagnose 癌症, 结节病, or an infection (such as tuberculosis):

• 当你或你的十大赌博平台排行榜感觉 淋巴腺肿大 它们不会消失
• When abnormal lymph nodes are present on a mammogram, ultrasound, CT, or 核磁共振成像扫描
• 对于一些癌症患者来说，比如乳腺癌或者 黑素瘤, to see if the 癌症 has spread (sentinel lymph node biopsy or needle biopsy by a radiologist)

The results of the biopsy help your provider decide on further tests and treatments.

正常的结果

If a lymph node biopsy does not show any signs of 癌症, it is more likely that other lymph nodes nearby are also 癌症-free. This information can help the provider decide about further tests and treatments.

异常结果意味着什么

Abnormal results may be due to many different conditions, from very mild infections to 癌症.

例如，淋巴结肿大可能是由于:

• 癌症(乳腺癌、肺癌、口腔癌)
• 艾滋病毒
• 淋巴组织癌(何杰金氏病 or 非霍奇金 淋巴瘤)
• 感染(肺结核、 猫抓病)
• Inflammation of lymph nodes and other organs and tissues (结节病)

风险

淋巴结活检可能导致以下任何一种情况:

• 出血
• Infection (in rare cases, the wound may get infected and you may need to take antibiotics)
• Nerve injury if the biopsy is done on a lymph node close to nerves (the numbness usually goes away in a few months)

参考文献

陈国强，张国强. 活检，部位特异性标本. 见:陈国强，张国强编. 实验室测试和诊断程序. 6日艾德. St Louis, MO: Elsevier Saunders; 2013:199-202.

Chung A, Giuliano AE. Lymphatic mapping and sentinel lymphadenectomy for breast 癌症. In: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, eds. The Breast: Comprehensive Management of Benign and Malignant Diseases. 5日艾德. Philadelphia, PA: Elsevier; 2018:chap 42.

国家癌症研究所网站. 前哨淋巴结活检. www.癌症.gov/about-癌症/diagnosis-staging/staging/sentinel-node-biopsy-fact-sheet. 2019年6月25日更新. 获得于2022年7月7日.

Young NA, Dulaimi E, Al-Saleem T. 淋巴结:细胞形态学和流式细胞术. 见:Bibbo M, Wilbur DC，编辑. 综合细胞病理学. 第四版. Philadelphia, PA: Elsevier Saunders; 2015:chap 25.