Rapid access lymph node biopsy

York and Scarborough Teaching Hospitals NHS Foundation Trust

Definition/Description

Patient presenting with suspicious lymph node

See flowchart below

Red Flag Symptoms

Suspicious lymph nodes

Guidelines on Management

Arrange urgent FBC, U&Es, LFTs and coagulation screen

 

Trucut +/- ultrasound guided biopsy if:

Suspect upper aerodigestive tract or other non-lymphoma cancers

Core biospy +/- ultrasound guided if:

  • A malignancy has been previously diagnosed? (e.g. primary melanoma) AND fine-needle aspiration cytology may be adequate (if non-diagnostic)
    OR
  • Has not had a malignancy previously diagnosed? (e.g. primary melanoma) AND is not clinically lymphoma

Arrange core biopsy if: 

  • Has not had a malignancy previously diagnosed? e.g. primary melanoma
    AND 
  • Is clinically lymphoma
    AND
  • CLL not diagnosed on FBC
    AND
  • Patient is systemically well and accepts risck of possible repeat biopsy

Arrange open lymph node biopsy if:

  • Has not had a malignancy previously diagnosed? e.g. primary melanoma
    AND 
  • Is clinically lymphoma
    AND
  • CLL not diagnosed on FBC
    AND
  • Patient is systemically unwell or urgent

Referral Criteria/Information

Refer to Head and Neck team if:

  • Single site above clavicle

Neck Lump Clinic Appointment 
Ext: x1021
Fax: 01904 726349


Refer to Haematology if:

  • there is lymphadenopathy at two or more sites and/or confirmed lymphocytosis on FBC

    OR
     
  • Has not had a malignancy previously diagnosed? e.g. primary melanoma
    AND 
  • Is clinically lymphoma
    AND
  • CLL diagnosed on FBC
Outpatient appointment
Ext: x5777


Refer to Breast Team if:

  • Single site below clavicle
Ext: x5116
Contact via switchboard (Outpatients)

Associated Policies

There are no associated policies.

Specialties

Breast York Breast North Yorkshire Haematology North Yorkshire Haematology York

Places covered by

  • North Yorkshire
  • Vale of York

Hospital Trusts

  • York and Scarborough Teaching Hospitals