Biopsy Examination: Lymph nodes or glands may be present on the surface of the body, for example, in the neck, axilla—the armpit or groin. From these places, it is not difficult to take out a whole gland and examine it histologically and also by culture for bacteria such as tubercle bocilli. But if the enlarged glands are present inside the body such as in the thorax or abdomen, then the part has to be operated upon and the gland removed.
Sometimes instead of removing the whole of the enlarged gland, a fine needle can be inserted in it and some part of it, the cells, sucked out with the syringe and examined histologically, which can reveal the diagnosis. The result can be available, depending upon the need, sometimes within an hour or a day or so.
Lymphangiogram: It is an X-ray of the lymph channels and the lymph glands of a particular part of the body, e.g. the legs or the abdomen. This is done to visualize the course, the dimensions of the vessels and the extent of the lymph glands.
The test is done in two parts spread over two days. A greenish-blue dye is first injected in the skin betweeen the first and second toes of each foot. The dye soon appears in fine lymph vessels on the skin over the feet.
Then with a very fine needle, a radio-opaque contrast dye is very slowly injected into one of the larger visible lymph vessels. This is a slow process and may take up to two to four hours. X-ray films are taken in between to see the extent of penetration of the dye in the legs and abdomen.
The next day, a further series of X-ray are done of the abdomen. In between and after the test, the patient will feel discomfort over the feet and legs, but it passess off soon.