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Does an enlarged lymph node need a biopsy?

Q: My daughter is 6 years old and has tiny lymph nodes and one enlarged lymph node in the left side of her neck. The chest x-ray shows no signs of TB. The complete blood picture was normal and the ESR is 9. The doctor suggested us to get a FNAC test but the radiologist suggested lymph node biopsy after confirming the node size as small on an ultrasound. Now we need to meet a surgeon to arrange for lymph node removal and FNAC biopsy. Please suggest how to go further.

A:A lymph nodal enlargement is not a disease. It is a reaction of the body to some infection in the areas drained by the respective nodes. So if you find an enlarged lymph node in the neck, the logical step would be to inspect the nose and the throat. The lymph nodes may also be enlarged due to dandruff and other scalp infections. A rare reason could be some lymph system diseases. Such lymph system diseases could only be diagnosed with a biopsy, and a biopsy is a straightforward procedure. In a child, this procedure needs general anaesthesia. Hence, after an ENT consultation and investigations, you may consider a biopsy.

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