38510 Biopsy or excision of lymph node(s); open, deep cervical node(s)

Name of the Procedure:

Biopsy or excision of lymph node(s); open, deep cervical node(s). Commonly referred to as Cervical Lymph Node Biopsy or Excision.

Summary

A cervical lymph node biopsy or excision is a surgical procedure used to remove one or more lymph nodes from the deep tissues of the neck for diagnostic or treatment purposes. This procedure can help diagnose conditions or diseases affecting the lymphatic system.

Purpose

Medical Condition or Problem it Addresses

• To diagnose lymphatic disorders, cancer, infections, or other diseases affecting the lymph nodes.

Goals or Expected Outcomes

• Obtain tissue samples for pathological examination.
• Remove diseased lymph nodes to prevent the spread of infection or cancer.
• Provide a definitive diagnosis to guide treatment.

Indications

Specific Symptoms or Conditions

• Unexplained swelling or enlargement of cervical lymph nodes.
• Persistent or recurrent infections.
• Suspicion of malignancy or metastasis to lymph nodes.
• Inconclusive results from less invasive tests.

Patient Criteria or Factors

• Individuals with palpable neck masses.
• Patients with symptoms indicative of systemic diseases like lymphoma or tuberculosis.
• Cases where imaging suggests lymph node abnormalities.

Preparation

Pre-procedure Instructions

• Fasting for a certain period before the procedure (usually 6-8 hours).
• Adjustments to current medications, particularly blood thinners.
• Arranging transportation post-procedure due to anesthesia effects.

Diagnostic Tests or Assessments

• Blood tests to assess overall health and blood clotting function.
• Imaging studies like ultrasound, CT scan, or MRI to locate the lymph nodes.

Procedure Description

Step-by-Step Explanation

1. Anesthesia: General or local anesthesia is administered to ensure comfort.
2. Incision: A small incision is made over the area of the target lymph node(s).
3. Lymph Node Removal: The lymph node(s) are carefully dissected and removed.
4. Closing Incision: The incision is closed with sutures or staples, and a sterile dressing is applied.

Tools, Equipment, or Technology

• Scalpel, forceps, surgical clamps, and scissors.
• Sterile drapes and dressings.
• Closure materials like sutures or staples.

Anesthesia or Sedation Details

• General anesthesia for entire body sedation or local anesthesia with sedation to numb the specific area.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the complexity and number of lymph nodes being removed.

Setting

Performed in a hospital's operating room, an outpatient surgical center, or a specialized clinic.

Personnel

• Surgeon: Performs the procedure.
• Anesthesiologist: Manages anesthesia.
• Surgical nurse or assistant: Provides support to the surgeon.

Risks and Complications

Common Risks

• Infection at the incision site.
• Bleeding or hematoma.
• Pain and swelling in the neck area.

Rare Risks

• Nerve damage leading to numbness or weakness.
• Damage to nearby structures like blood vessels.

Possible Complications

• Prolonged or severe pain.
• Delayed wound healing.
• Adverse reaction to anesthesia.

Benefits

Expected Benefits

• Accurate diagnosis of diseases affecting lymph nodes.
• Removal of potential disease sources.
• Guiding further treatment options effectively.

Realization Timeline

• Immediate diagnostic results within a few days to a week.
• Clinical benefits depend on the underlying condition treated.

Recovery

Post-procedure Care

• Rest and limited physical activity.
• Keeping the incision site clean and dry.
• Pain management with prescribed medications.

Expected Recovery Time

• Most patients can return to regular activities within 1-2 weeks.
• Follow-up appointments for suture removal and to discuss pathology results.

Alternatives

Other Treatment Options

• Fine-needle aspiration (FNA) biopsy.
• Core needle biopsy.
• Watchful waiting if clinically appropriate.

Pros and Cons Compared

• FNA Biopsy: Less invasive, quicker recovery, but potentially less definitive.
• Core Needle Biopsy: More tissue sample than FNA, less invasive than open biopsy, but sometimes inconclusive.
• Watchful Waiting: No immediate intervention, but risk of delayed diagnosis.

Patient Experience

During the Procedure

• Sedation ensures minimal discomfort; local anesthesia causes numbness in the area.

After the Procedure

• Mild to moderate pain and swelling, managed with pain relievers.
• Sensation of tightness or numbness around the incision.
• General rest and care instructions to promote healing and avoid infection.