Excisional Biopsy: Neck Lymph Node

Excisional Biopsy: Neck Lymph Node

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Excisional Biopsy: Neck Lymph Node

The lymph nodes are part of the immune system. These small organs are located throughout the body. There are many of them in the neck. Neck lymph nodes sometimes enlarge. This is most often due to infection, but it can also be caused by cancer. Excisional biopsy helps find the cause of an enlarged lymph node. You may have already had other tests, such as a needle biopsy, but more information is needed for your doctor to diagnose the problem. During an excisional biopsy, part or all of the enlarged lymph node is removed. The removed tissue is then sent to a lab for study. This sheet explains the biopsy procedure and what to expect.

Side view of the neck and head showing the lymph nodes.

Preparing for the Procedure

Prepare for the surgery as you have been instructed. Be sure to tell your doctor about all medications you take. This includes over-the-counter drugs. It also includes herbs and other supplements. You may need to stop taking some or all of them before surgery. Also, follow any directions you’re given for not eating or drinking before surgery.

The Day of the Procedure

The procedure takes about 60 minutes. Most people go home the same day.

Before the procedure begins:

An IV line is put into a vein in your arm or hand. This line delivers fluids and medications.

  • You will be given medication (anesthesia) to keep you free of pain during surgery. This may be sedation, which makes you relaxed and sleepy. Local anesthesia is also injected near the lymph node to numb the area. Or, you may receive general anesthesia. This puts you into a state like deep sleep.

During the procedure:

  • The skin over the enlarged lymph node is marked and cleaned.

  • An incision is made through the skin. If possible, the incision is made within the creases of the neck. This makes it less noticeable when it has healed.

  • Part or all of the enlarged lymph node is removed. It is sent to a lab for testing.

  • The incision is closed with sutures, staples, surgical glue, or surgical strips. It is then bandaged.

  • A tube (drain) may be placed near the incision. This drains fluids that may build up after the procedure.

After the Procedure

You will be taken to a room to wake up from the anesthesia. You may feel sleepy and nauseated at first. Medication will be given to manage any pain. If you have a drain, you will be shown how to care for it. When you are ready to go home, have an adult family member or friend drive you. Follow your doctor’s instructions for recovery, such as:

  • Take any prescribed medication as directed.

  • Care for your incision as instructed.

  • Avoid strenuous activity until your doctor says it’s okay.

When to Call the Doctor 

Be sure you have a contact number for your doctor. After you get home, call this number if you have any of the following:

  • Chest pain or trouble breathing (call 911)

  • Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

  • Soreness at the biopsy site

  • Difficulty turning your head

  • Symptoms of infection at an incision site, such as increased redness or swelling, warmth, worsening pain, or foul-smelling drainage

  • Bleeding or bruising at the incision site

  • Numbness or tingling in the mouth, jaw, neck, arm, or shoulder

  • Problems speaking or swallowing

  • Hoarse voice that worsens


During follow-up visits, your doctor will check on your healing. If you have a drain, it will be removed 1-2 days after the procedure. Stitches or staples are removed about 7-10 days after the procedure. You and your doctor will also discuss your biopsy results. If cancer was found, further treatment may be needed.

Risks and Possible Complications

Risks of this procedure include:

  • Bleeding

  • Infection

  • Injury to the spinal accessory nerve, affecting movement of the shoulder (could be temporary or permanent)

  • Injury to sensory nerves, affecting sensation of the earlobe, neck, or skin of the neck (could be temporary or permanent)

  • Neck abscess

  • Scarring

  • Reopening of the incision

  • Recurrence of the enlarged lymph node

  • Risks of anesthesia (you will discuss these with the anesthesiologist)