The diagnostic value of biopsy of small peripheral lymph nodes in patients with suspected lymphoma.

In a patient with suspected lymphoma, it is considered desirable to confirm the diagnosis by excisional biopsy of enlarged lymph nodes. However, sometimes the ideal nodes are positioned internally, requiring a deep invasive procedure for access, or the patient may have underlying medical conditions that make it risky to perform such an invasive procedure. Under a protocol approved by our institution's review board (IRB), we reviewed five patients in whom superficial lymph nodes were biopsied which were smaller than usually considered optimal for diagnosis (=2 cm). In each of these cases, the biopsy yielded diagnostic information upon which treatment could be based, sparing the patient a deep invasive procedure. We suggest that in situations in which large internal lymph nodes are not easily accessible and/or the patient's clinical situation precludes more invasive procedures, including deep core needle biopsy of a large mass, it is worthwhile to consider the removal of smaller, superficial lymph nodes with minimal risk which may suffice for diagnosis.