Lymph Node Biopsy with Reflex IHC Test: Booking, Price, and Results
About Lymph Node Biopsy with Reflex IHC Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | Histopathology Lymph Node Biopsy with Reflex IHC, Lymph Node IHC Panel, Lymph Node Biopsy with Immunohistochemistry |
| Sample Type | Lymph node tissue (preserved in 10% formalin) |
| Fasting Required | No fasting required for the test itself; fasting may be needed if general anaesthesia is used for the biopsy procedure |
| Report Time | 6 Days |
| Recommended For | Individuals requiring evaluation of persistent lymph node enlargement or suspected malignancy |
| Price | Starting at ₹5,000 |
What Is a Lymph Node Biopsy with Reflex IHC Test?
The Lymph Node Biopsy with Reflex IHC test is a specialised diagnostic procedure in which a tissue sample obtained from a lymph node is examined under a microscope by a pathologist. If the initial histopathological examination is inconclusive or raises suspicion of malignancy, immunohistochemistry (IHC) is automatically performed using selected antibodies to identify specific cellular markers and aid diagnosis. This combination of methods helps doctors accurately identify the nature of an abnormality in the lymph node. The test is also referred to as Histopathology Lymph Node Biopsy with Reflex IHC or the Lymph Node IHC Panel.
What Does a Lymph Node Biopsy with Reflex IHC Test Measure?
This test examines the structure and cellular make-up of lymph node tissue. The initial histopathological examination looks at tissue architecture and cell appearance. Depending on the histopathological findings, the following markers may be assessed during reflex immunohistochemistry (IHC):
- Histopathological examination: Microscopic review of the tissue to assess cell shape, structure, and arrangement, as well as the presence of abnormal cells.
- CD20 (B-cell marker): Identifies B-cells (a type of white blood cell); diffuse expression may support the diagnosis of B-cell lymphoma when interpreted alongside histopathological findings.
- CD3 (T-cell marker): Identifies T-cells (another type of white blood cell); diffuse expression may point towards T-cell lymphoma.
- CD10, CD23, BCL-2, BCL-6: Additional markers that help further classify lymphoma subtypes based on tissue patterns.
- Ki-67: Reflects how rapidly cells are dividing; a high value may indicate an aggressive tumour.
- Cyclin D1: Identifies Cyclin D1 protein overexpression characteristic of mantle cell lymphoma.
- LCA (CD45): Confirms the presence of lymphoid cells within the sample.
Why Is a Lymph Node Biopsy with Reflex IHC Test Done?
Doctors order this test when lymph node abnormalities cannot be explained by routine investigations alone. It provides a precise tissue-level diagnosis.
Common Symptoms That May Require This Test
The following symptoms are among the most common reasons a doctor may recommend this test:
- Swollen or enlarged lymph nodes that persist for more than 2 to 3 weeks
- Unexplained weight loss
- Persistent fatigue without a clear cause
- Ongoing fever or night sweats
- Loss of appetite
- Shortness of breath
- A visible lump or mass near a lymph node region
Conditions This Test Can Help Detect
This test is used to help identify a range of conditions, including:
- Lymphoma (Hodgkin's and non-Hodgkin's types): cancer originating in the lymphatic system
- Metastatic cancer: cancer that has spread to the lymph nodes from another part of the body
- Tuberculosis and other infections: including bacterial, viral, fungal, or parasitic infections that may cause lymph node enlargement
- Sarcoidosis: an immune condition that causes clusters of inflammatory cells in body tissues
- Reactive lymphoid hyperplasia: benign enlargement of lymph nodes in response to infection or inflammation
How to Prepare and What to Expect
Preparing for this test involves some steps before the biopsy procedure itself. Here is what to keep in mind.
Do You Need to Fast?
No fasting is required for the laboratory analysis. However, if your biopsy is performed under general anaesthesia, your doctor will advise you to fast for several hours beforehand. Follow your doctor's specific instructions in that case.
Practical Tips Before Your Test
The following steps will help ensure a safe and smooth procedure:
- Bring a detailed clinical history including your symptoms, previous test results, and family history, as this is required for the test.
- Inform your doctor about all medicines, vitamins, supplements, and herbal remedies you currently take, especially blood thinners such as aspirin.
- Arrange for someone to take you home if sedation or general anaesthesia is involved, as you may feel drowsy afterwards.
- Wear comfortable, loose-fitting clothing to allow easy access to the biopsy site.
Step-by-Step Procedure
Here is what typically happens during sample collection and processing:
- The biopsy site is cleaned, and a local anaesthetic is applied to numb the area before any incision is made.
- A small surgical cut is made, and the lymph node or part of it is carefully removed. The incision is then closed with stitches, and a bandage or adhesive is applied.
- The tissue sample is placed immediately in a container containing 10% neutral buffered formalin, which preserves tissue architecture and prevents degradation.
- In the laboratory, the preserved tissue is embedded in paraffin wax and cut into very thin slices to prepare glass slides for microscopic review.
- If the initial microscopic examination is inconclusive or suggests malignancy, IHC is triggered automatically. Specific antibodies are applied to the slides, binding to target proteins within the cells.
- A pathologist examines the stained slides under a microscope and prepares a detailed report based on the staining patterns observed.
Factors That Can Affect Accuracy
Several factors can influence the quality of results:
- Prior chemotherapy or radiotherapy, which may alter cell appearance
- Inadequate tissue sample size
- Poor or delayed formalin fixation of the tissue
- Quality of the antibodies used during IHC staining
Understanding Your Lymph Node Biopsy with Reflex IHC Test Results
Results from this test are detailed and require expert interpretation. The table below provides a general guide to findings. Always review your report with your treating doctor.
| Parameter | Normal Finding | Abnormal Interpretation |
|---|---|---|
| Histopathology | Normal lymph node architecture preserved | Disruption of architecture may suggest malignancy or serious infection |
| CD20 | Positive in B-cell areas (germinal centres) | Diffuse strong expression may indicate B-cell lymphoma |
| CD3 | Positive in T-cell areas (paracortex) | Diffuse strong expression may indicate T-cell lymphoma |
| BCL-2 | Negative in germinal centres | Positive germinal centre staining may suggest follicular lymphoma |
| Ki-67 | Low proliferative index in normal tissue | High index may indicate aggressive lymphoma |
Disclaimer: These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
How to Maintain Healthy Levels
Although this test is used for diagnosis rather than monitoring a specific parameter, the following habits may help support overall immune and lymphatic system health:
- Seek medical attention promptly if swollen lymph nodes persist for more than two to three weeks.
- Eat a balanced diet with adequate fruits, vegetables, and whole grains to support immune function.
- Avoid smoking and limit alcohol intake, as both are associated with increased cancer risk.
Lupin Diagnostics Lymph Node Biopsy with Reflex IHC Test Price
The Lymph Node Biopsy with Reflex IHC test cost starts at ₹5,000 at Lupin Diagnostics. This test requires a visit to a Lupin Diagnostics centre; home collection is not available for this test.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 5000 |
| CHENNAI | 5000 |
| HYDERABAD | 5000 |
| KOLKATA | 5000 |
| NAVI MUMBAI | 5000 |
| PUNE | 5000 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Follow these steps to book your Lymph Node Biopsy with Reflex IHC test at Lupin Diagnostics:
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time for sample collection.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
A regular biopsy involves examining lymph node tissue under a microscope to look at cell structure. In a Lymph Node Biopsy with Reflex IHC test, immunohistochemistry is automatically performed if the initial examination is inconclusive or suggests cancer. This additional step uses specific antibodies to identify protein markers and helps classify the exact type of abnormality present.
Reports are typically available within 6 days. The turnaround time can vary depending on the complexity of markers required and the specific findings during the initial examination.
Local anaesthesia is injected into the area before the procedure begins. You may feel mild pressure or minor discomfort, but significant pain is generally well-controlled. Your doctor will guide you on post-procedure care.
No single marker is sufficient to diagnose lymphoma on its own. A panel of markers is selected based on what the initial microscopic examination suggests, allowing the pathologist to confirm the cell type involved and classify the specific subtype of the condition accurately.
No. The lymph node biopsy with reflex IHC test procedure requires a trained healthcare professional to collect a tissue sample in a medical setting. This cannot be performed at home.
Abnormal results should be discussed with a haematologist (a specialist in blood disorders) or an oncologist (a cancer specialist). They will review your full clinical picture and guide you on the appropriate next steps.
The procedure is generally safe. You may experience mild bleeding, bruising, or discomfort at the biopsy site. There is a small risk of infection, which is treatable. If the biopsy is performed near nerves, temporary numbness or altered sensation may occasionally occur. In most cases, symptoms improve gradually over time.
Lymph Node Biopsy with Reflex IHC Test: Booking, Price, and Results
