CERVICAL NODE
GENERAL INFORMATION
The whole body is fitted out with a huge number of
microscopic channels that drain fluid called lymph.
These channels pass through lymph nodes, whose
function it is to filter out and trap bacteria,
viruses, white blood cells, cancer cells and other
foreign particles in the lymph. When the lymph nodes
trap a lot of material, they swell. Sometimes they
swell simply as part of their job in helping the
body fight off an infection. The lymph nodes are
more concentrated in certain areas, for example the
neck.
It is sometimes difficult to know the cause of
swelling of lymph nodes. In such situations, a
portion or all of the lymph node needs to be
removed. This is called a LYMPH NODE BIOPSY.
COMMON SIGNS AND SYMPTOMS
- The enlarged lymph node can be as small as a pea
or as large as a walnut. Only one node may be felt,
or there may be many. They may be separate or stuck
together.
- Usually they do not hurt, or they may just ache a
bit.
- The surest way to be certain of the nature of the
lymph node is to remove a piece of it for
examination in the laboratory. However, there are a
number of considerations on whether a biopsy is
necessary or advisable.
- The lymph nodes may not truly be enlarged. The
person may be thin enough that normal, small nodes
can be felt.
- If the cause of the enlargement is clear and not a
serious one, the proper first step is to treat the
cause (for example an infection) expecting the lymph
node to get smaller.
- Sometimes the specific cause of the lymph node
swelling is not clear to the doctor, but the
possible causes are not alarming. In such cases, it
may be reasonable to simply observe the patient for
several weeks or several months.
- The diagnosis may not be clear, but there may be
serious harm in waiting and watching to see what
happens. In such a case, a biopsy is warranted.
- The diagnosis may be quite obvious. However the
treatment for the presumed disease is extensive and
carries some risk. It would not be correct to start
treatment without first knowing the exact diagnosis
through a biopsy.
PRE-OPERATIVE PREPARATION
- Don't drink or eat anything for 6 hours before the
operation.
- Your doctor will decide when you need to be
admitted to hospital.
- You may be given medicine to make you drowsy
before being taken to the theatre.
- Make sure your doctor knows what medicines you
take, especially medicines which may affect blood
clotting.
OPERATION
- Your doctor may decide to do the biopsy under
local anaesthetic or under general anaesthetic.
- An incision is made over the enlarged lymph node.
It is dissected out.
POST-OPERATIVE CARE
- You will be taken to a recovery room where you
will stay until your blood pressure, pulse and
breathing are stable and you are completely alert.
You should be able to go home the same day with a
responsible adult.
- Arrangements will be made regarding the removal of
your stitches.
COMPLICATIONS
1. Complications are not common after a cervical
node biopsy but you must be aware of the following
possible complications.
2. A bleed or haematoma at the site of a lymph node
biopsy may rarely occur. Depending on the extent of
this bleed, your doctor will decide whether you need
to be taken back to the operating theatre.
3. The wound of a cervical node biopsy rarely
becomes infected. If this happens, it may
necessitate dressings or other active management.
4. The scar after this operation is usually quite
satisfactory, but some patients may end up with an
unattractive scar.
5. Some very important nerves run through the neck
on the way to the shoulder and arm. It is very rare
for them to be injured. You must however be aware of
the fact that these nerves may be injured with
significant repercussions for arm and shoulder
function.
6. Systemic complications like venous thrombosis and
pulmonary embolism are rare but possible after any
operation or anaesthetic.
pil-cervical node.doc/ver2/20 January 2002 |
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