Although enlarged lymph nodes are a common occurrence, there are situations when a doctor may be suspicious that the underlying cause is something more than a simple infection. Several diagnostic tests can be used to pinpoint the cause and develop a treatment plan if needed.
X-ray is frequently used when a patient has suspicious lymph nodes, especially when they have other symptoms that might indicate a malignancy. A chest x-ray can help spot suspicious growths that may occur with lymphoma. In some cases of lymphoma, the thymus may be enlarged, or there are deeper enlarged lymph nodes in the chest. A chest x-ray may also show indications of a mass in the breasts or lungs. Since x-rays are fast and inexpensive, they can be used to quickly determine if a patient's condition warrants further testing or emergency treatment, such as removal of a mass.
Computed tomography (CT) may be used to gain clearer images of the head, chest, abdomen, and pelvis. In the case of enlarged lymph nodes, the doctor may be looking for any indication of a mass or primary tumor. Other indications of a serious problem that may show up on a CT scan is enlargement of the spleen and/or liver. Enlargement of these organs may be indicative of blood cancers, such as lymphoma or leukemia. Metastatic cancers may also cause enlargement of these organs. Depending on what the doctor is looking for, the CT scan may be performed with or without a contrast medium. Contrast can make it easier to distinguish different structures within the body. A doctor might also request a head CT if a patient's symptoms raise concerns of a potential malignancy that may have spread to the brain.
Lymph Node Biopsy
A lymph node biopsy is one of the most useful tools in making a definitive diagnosis of enlarged lymph nodes. In some cases, a doctor might request a sample taken via a fine-needle biopsy. During this procedure, ultrasound is used to visualize the affected lymph node. A small needle can be inserted under local anesthetic and used to withdraw a small tissue sample that will be sent to the pathology lab.
Some doctors may request a traditional lymph node biopsy instead of a fine-needle biopsy to have a more accurate diagnosis. Typically the patient is sedated with general anesthesia for a biopsy, which requires a small incision to remove one or more suspicious lymph nodes. Results from the pathology lab are used to indicate whether the enlarged lymph nodes are benign or malignant. Furthermore, if there is evidence of a malignancy, the pathologist can determine whether it is a primary cancer affecting the lymph nodes or a metastatic cancer.
When enlarged lymph nodes do not go away after a few weeks or they accompany concerning symptoms, further testing is needed to rule-out a malignancy. There are several tests used to make an accurate diagnosis and coordinate the best treatment plan if the lymph nodes are positive for cancer. For more information, contact companies like Hudson Valley Imaging.