Neck Lymph Nodes

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What is Neck Lymph Node biopsy and surgery? 

A neck lymph node biopsy and surgery is an investigative and treatment pathway recommended in Singapore when patients present with symptoms that indicate diseases in the lymph nodes. Neck lymph nodes, also known as the cervical lymph nodes, comprise a part of the lymphatic system that filters and destroys foreign substances, such as cancer cells and infections. Thus, an enlarged or swollen lymph node may subsequently indicate a dysfunction of the lymph nodes present at the neck. 

Cervical lymph nodes
Enlarged lymph nodes at the neck may occur anywhere from behind the ears, under the jaw, or at the sides of the jugular

Generally, a neck lymph node biopsy and surgery are suggested when patients present with swollen lymph accompanied by other symptoms such as: 

  • Lymph node that is tender and painful 
  • Lymph node that is increasing in size 
  • Fever and night sweats 
  • Sore throat 
  • Palpably hard lymph nodes

Swollen lymph nodes are usually identified during a routine examination or when patients actively seek solutions to the discomfort caused by the growth. Neck lymph node biopsy and surgery are warranted when the cause of swelling is ambiguous or if your endocrinologist suspects diseases such as upper respiratory tract infections, cancers, and immune system disorders. 

Swollen neck lymph node 
A swelling that is progressively growing, causing significant discomfort, and is hard to the touch warrants a neck lymph node biopsy and surgery.

How does Neck Lymph Node biopsy and surgery work?

The mechanism of neck lymph node biopsy and surgery can be broken down into two parts. First, the biopsy entails either extracting a sample from the swollen lymph nodes or completely removing it. Next, the lymph node or the sample is sent to a lab for examination to obtain a definitive diagnosis. A neck lymph node biopsy can be executed in a few different ways: 

  • Needle biopsy: also known as an ultrasound-guided fine needle biopsy, this is a short procedure in which a fine needle is inserted into the lymph node to remove and subsequently collect some samples. Numbing cream will be applied during this procedure to minimise discomfort. 
  • Open biopsy: a surgical procedure that entails removing part (incisional) or all (excisional) of your lymph node. Also known as neck dissection or cervical lymphadenectomy, local anaesthesia is administered during the procedure to ensure a painless and comfortable experience. Removal of lymph nodes may be necessary if your doctor suspects a risk of cancer and subsequent spread. 
  • Sentinel biopsy: typically reserved for patients diagnosed with cancer such as thyroid cancer (link to service page) to determine the potential site of spread (metastasis). Sentinel biopsy involves injecting blue dye, known as a tracker, to assess the extent of cancer spread in the lymph node.

Benefits of Neck Lymph Node biopsy and surgery in Singapore

  • Provides definitive diagnosis and unveils cause of lymph node enlargement. 
  • Provides an opportunity for early intervention, subsequently reducing the risk of disease progression. 
  • Informs the appropriate treatment to employ, consequently increasing chances of recovery. 
  • Reduces pain or discomfort caused by swelling or enlargement. 

What conditions can Neck Lymph Node biopsy and surgery treat in Singapore?

An enlarged or swollen lymph node may indicate an array of health conditions. Therefore, a neck lymph biopsy and surgery would be recommended accordingly for the following: 

  • Lymphoma: biopsy is required to diagnose and identify the stage of cancer
  • Lupus: to diagnose Lupus and subsequent removal of lymph nodes may be recommended to prevent the condition’s progression to non-Hodgkin's lymphoma, Hodgkin lymphoma, and leukaemia
  • Infections: in some cases, biopsy and surgery may be necessary where lymph node infections are persistent and resistant to treatment. 
  • Inflammatory conditions: biopsy and surgical intervention would be recommended for inflammatory conditions such as sarcoidosis or Castleman disease

If you suffer from a salivary gland disorder, schedule an appointment with ACE Surgery & Endoscopy for a detailed medical assessment and personalised treatment options. 

Lymphoma 
Neck lymph node biopsy and surgical intervention are necessary for diagnosing and preventing the progression of conditions such as lymphoma. 

What results can I expect from Neck Lymph Node biopsy and surgery? 

The results of a neck lymph node biopsy and surgery vary depending on your diagnosis. This diagnosis and treatment solution will clarify the underlying condition that manifests symptoms of enlarged and swollen neck lymph nodes. Thus, this provides an opportunity to plan the appropriate treatment for you. 

In some cases, the surgical intervention may serve as a treatment, particularly in persistent infections. The role of neck lymph node biopsy and surgery is subjective to your condition. Your doctor will exhaustively brief you on what you can expect. You will receive a customised treatment plan and a recovery plan upon completion of surgery. 

How many treatment sessions of Neck Lymph Node biopsy and surgery are needed?

Typically, this is a one-off procedure. Upon diagnosis and surgical intervention, you will be guided to recovery. However, in cases where patients are diagnosed with cancer, you may be required to return to our clinic to monitor your condition, to investigate if you are responding positively to treatment, and if relapse has occurred. You will be informed accordingly if a follow-up biopsy and surgery are needed. 

It is also important to note that biopsy and surgical intervention may be conducted separately. Often, the necessity for a surgical intervention can only be determined after a definitive diagnosis is obtained. 

If you suffer from a salivary gland disorder, schedule an appointment with ACE Surgery & Endoscopy for a detailed medical assessment and personalised treatment options. 

Frequently Asked Questions

Do all neck lymph node biopsies require surgery?

No. The subsequent surgical intervention necessity will depend on your specific diagnosis. For instance, if an infection causes the enlargement of the neck lymph node, you will first be prescribed medications and other conservative treatment options to manage your condition. Only when infections persist would surgery be recommended. 

How painful is neck lymph node biopsy and surgery?

The level of pain varies depending on the specific type of biopsy that is conducted. However, you will be administered local anaesthesia or numbing cream to ensure you do not undergo unnecessary discomfort and pain. Additionally, you will also be prescribed painkillers post-treatment to manage your pain levels if deemed necessary. 

How long is the neck lymph node biopsy and surgery procedure?

This will also depend on the specific type of biopsy and the type of surgery performed (partial or full lymph node removal). If you undergo a fine needle biopsy, your procedure may be completed within 5-10 minutes. However, if an open biopsy is deemed necessary, this may take up to an hour. 

Will I have to be admitted to a hospital for neck lymph node biopsy and surgery?

If a fine needle biopsy is required, this will be done in our clinic, and you can return home upon completion. In open biopsy and surgery cases, you may be required to stay in the hospital to monitor your condition. The exact requirement will be discussed before commencing biopsy and treatment

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Reyaz Moiz

Dr Reyaz Singaporewalla
Senior Consultant Endocrine and General Surgeon

MBBS (Bom), MS (Surg), DNB (Surg), FRCS (Edin), MMed (Singapore), FRCSEd.