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[Value and limits of different method in diagnosis and differential diagnosis of retroperitoneal tumors within the lymphatic systems (author's transl)].

The demonstration of retroperitoneal intralymphatic primary or secondary tumors requires a progressive radiological investigation beginning with simple methods and advancing to more complicated ones. Radiological lymphography is a method which is superior due to its ability to demonstrate small structures in lymphatic vessels and lymphnodes. However, the usefulness of lymphography is limited partially to the retroperitoneal lymphatic system and to gross changes. To improve diagnostic accuracy further diagnostic measures are needed, namely intravenous urography, venocavography, lumbar venography of catheter, sonotomography of the upper abdomen and lymphatic scintigraphy. Exstirpation of lymphnodes- possibly by explorative laparotomy- and histopathological examination enables an extact assessment of lymphnodes of microscopical dimension as determination of the tumor type. The value and limits of complementary methods and the criteria for the diagnosis and differential diagnosis of metastatic lymphnodes and lymphoreticular systemic diseases are discussed. The significance of lymphography for evaluation of topographic expansion of pathological lymphnode changes, the further course of the disease and the effect of therapy according to the authors' experience are presented. It is stressed that the value of lymphography in diagnosing the type of disease is limited.

Adult↗

[Treatment of cancer of the esophago-gastric junction with special reference to dissection of the lymphatic system].

No means have yet been devised for detecting cancer of the esophago-gastric junction at an early stage, and no effective chemotherapy or irradiation regimen for this area is yet available. Recently, a very important lymphatic pathway and extension route for E. G-junction cancer has been discovered. A new operative procedure involving a thoraco-abdominal approach, wide dissection of the lymphatic system and safe reconstruction is discussed in this paper.

Adenocarcinoma↗

Immunosuppressive effect of total body irradiation and cyclosporine A on graft survival and the lymphatic system in a cardiac hamster-to-rat transplantation model.

The aim of the study was to evaluate the effect of total body irradiation (TBI) and cyclosporine A (CyA) on graft survival and the lymphatic system in a concordant hamster-to-rat heart transplantation model, and to compare these effects with those of total lymphoid irradiation (TLI). Preoperatively TBI was given as a single dose of 5 Gy, CyA was given intramuscularly at a dose of 10 mg/kg/day. TBI prolonged graft survival to seven days. Combined TBI and CyA prolonged graft survival to ten days. The effect of TBI on graft survival, total white blood cell count (WBC) and differential counts was reproducible but not as distinct as the effect of TLI. Analysis of changes in WBC and differential counts combined with the morphology of the grafts at rejection and of spleens from TBI- and CyA-treated animals indicates a reproducible immunosuppressive effect of TBI and a severe type of acute humoral rejection with vasculitis and cellular infiltrates dominated by macrophages and neutrophilic granulocytes. In conclusion, we find TBI a simple pretreatment which may be useful in combination with other immunosuppressive treatment as preoperative induction and depletion therapy.

Animals↗

Resistance in the sheep's lymphatic system.

Saline was infused in a downstream direction into the afferent lymphatics in the metacarpal region of anesthetized sheep. The changes in inflow pressure were measured over 10 min periods with flow rates ranging from 10-2000 microliters/min. Flow rates in the physiological range generated mean pressures of about 30 mmHg and flows of 1 ml/min generated mean pressures of about 60 mmHg. Resistance was relatively high at flow rates in the range of 10-15 microliters/min but sharply decreased above that and was relatively constant at flows greater than 500 microliters/min. Adding isoprenaline (1 microgram/min) to the infusate reduced spontaneous contractile behavior in the infused system and lowered the resistance at the lower flow rates. It is concluded that the peripheral lymphatic system in the sheep offers substantial resistance to lymph flow and that substantial intralymphatic pressure is needed to return lymph from the periphery especially at higher flow rates.

Animals↗