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[Value of lymphography within the framework of complex diagnosis of fever of unknown origin].

After comprehensive diagnostics on account of antibiotic-resistant subfebrile temperatures under suspicion of a lymphogranulomatosis a lymphography was performed in a 49-year-old patient. The lymphographic findings are discussed in detail. Since these findings differential-diagnostically allow a tuberculosis of the lymph nodes, a tuberculostatic therapy is performed. 6 months later the patient has an improved general condition and may again work in this former profession.

Diagnosis, Differential↗

[Clinical application of 113mIn-chloride for indirect lower radionuclide lymphography in cancer patients].

Carrier-free applications of 113mIn-chloride for indirect lower radionuclide lymphography were studied in 90 cancer patients. The period of radiolabel semiexcretion from site of injection (initial interdigital spaces of foot) ranged 25-74 min. 131mIn-chloride application provided a distinct visualization of retroperitoneal lymph nodes. The results of a radionuclide lymphographic study of 43 patients with uterine carcinoma were confirmed by postoperative histological examination of resected lymph nodes in 88%. The informative value of the pictures of retroperitoneal lymph nodes obtained by gamma chambers and scanners using 131mIn-chloride was essentially identical.

Diagnostic Errors↗

[Indirect isotopic lymphography. Technic and clinical applications].

Interstitial lymphoscintigraphy is a diagnostic method useful in the staging and follow-up of several tumours as well as in the etiological evaluation of limb edema. It is a simple technique with minimal invasivity which can be performed even in those regions inaccesible to radiographic lymphography. Because of its great sensitivity and low specifity it requires careful interpretation.

Ascites↗

Iotasul, a water-soluble contrast agent for direct and indirect lymphography. Results of preclinical investigations.

Iotasul, a non-ionic dimeric water-soluble contrast agent with outstanding physico-chemical properties is well suited for direct as well as indirect lymphography, as demonstrated in experimental animals. The contrast medium is eliminated practically completely within 24 hours by the renal route. The tolerance of this agent is far better than that of oily contrast media.

Animals↗

Accidental visualization of mesenteric lymph nodes by bipedal lymphography.

A case is presented of mesenteric lymph nodes filling accidentally by bipedal lymphography. The radiographs were interpreted erroneously as pathologic; consequently the patient was treated with chemotherapy and radiotherapy. The correct diagnosis was made later by explorative laparotomy.

Diagnostic Errors↗

[Indirect lymphography of the urinary bladder in animal experiments (author's transl)].

Of three contrast media injected interdigitally and submucosally as well as instilled into the bladder, Lipiodol UF (particle size of over 15 micron) and the experimental compound AG 52-315 were not resorbed. Another experimental compound (AG 60-99) with an iodine content of 20% and a particle size of ca. 3,5 micron produced, when injected interdigitally, good contrast of the popliteal lymph nodes in all cases (n = 5). Instillation of the same contrast medium into the bladders of five dogs yielded subdued contrast of the paravesicular lymph nodes in one case. Of still another five animals, two showed contrast of the inner iliac lymph nodes after submucosal infiltration of the bladder mucosa with AG 60-99. In all cases (n = 15) inflammatory reaction with necrotic formations were observed. Resorption of the contrast medium was accomplished by heating at 39 degrees C, and was not improved by addition of Hyaluronidase. Because of the low local tolerance of the contrast medium preparation, this successful experiment in indirect lymphography of the urinary bladder of animals cannot be applied clinically.

Animals↗

Transtracheal mediastinal lymphography for visualization of metastatic lymph nodes in carcinoma of the esophagus.

Mediastinal lymphography was carried out preoperatively upon 15 patients with carcinoma of the thoracic part of the esophagus. The tracheal bifurcation was punctured, and contrast medium was slowly injected. Mediastinal lymphograms were taken within 24 hours and, again, three and seven days after this injection. The paratracheal lymph nodes were demonstrated in almost all of the patients, and a filling defect was observed in three patients, leading to possible metastatic involvement. In seven patients, the right pulmonary hilar lymph nodes were demonstrated, and no node was considered to be metastatic. In three, paraesophageal lymph nodes were preoperatively diagnosed as metastatic. All seven lymph nodes in which metastasis was suspected were confirmed to be metastatic at pathologic examination. The smallest node correctly assessed as metastatic was 6 by 6 millimeters.

Aged↗

[External retromalleolar lymphography of the superficial and deep lymphatics of the lower limb (author's transl)].

External retromalleolar lymphography was employed to explore lower limb lymphatics in 39 patients. Though this type of approach enables deep lymph vessels of the thigh to be studied--at the price of a more difficult catheterization than when the classical approach is used--it is ineffective for demonstrating deep lower leg lymph vessels, filling occurring only in the superficial network. Its indications are therefore limited to cases following unsuccessful attempts with the classical approach.

Humans↗

Lymphography for fever of unknown origin-a reappraisal.

Among the lymphograms of 25 F.U.O. patients whose diagnoses were unknown after several weeks of detailed examinations, abnormalities were noted in 4. Of the 4 abnormal cases, 2 were finally diagnosed by superficial lymph nodes biopsies as having malignant lymphomas. The other 2 had no final diagnoses; though biopsies of enlarged superficial lymph nodes were performed, they showed only reactive hyperplasia. No exploratory laporatomy was performed among the 25 cases. We conclude that lymphography is not absolutely indicated in the evaluation of F.U.O.

Adolescent↗

Lymphography in surgically unresectable adenocarcinoma of the exocrine pancreas.

Bipedal lymphograms were performed on 28 consecutive previously untreated patients with biopsy proven and surgically unresectable carcinoma of the pancreas. Four of these patients had findings indicating lymph nodes metastases. In three of these 4 patients, the lymphogram provided the only evidence of metastatic disease. The information provided by bipedal lymphography may be useful in treatment planning.

Adenocarcinoma↗

[Lymphography of the thyroid gland. 1].

The authors carried out a lymphographic examination in 11 patients with various diseases of the thyroid gland. Lymphography proved to be an effective and harmless diagnostic method in pathological changes of the thyroid gland. Different structure of the thyroid gland tissue was revealed on the lymphograms depending on the character of the pathological process. In establishment of the diagnosis one should take into consideration the structure of the thyroid gland tissue, the structure of the cervical lymph nodes, and possibilities of their filling with the contrast agent, the amount, the rate and difficulties encountered in the administration of the contrast substance.

Adolescent↗

[Allergic reaction to patent blue at lymphography (author's transl)].

The authors report three cases of severe and three cases of mild allergic reactions due to Patent Blue being used for the visualization of the lymphatic vessels at lymphography. The therapy and the possibilities of the prevention of this complication are discussed particularly.

Adult↗

[Endoscopic gastroduodenal lymphography with opacification in the diagnosis of penetrating ulcers].

The authors describe the method of endoscopic gastroduodenal lymphography with opacification and its results obtained after treatment of 79 patients with peptic ulcers. The method of diagnosing penetrating ulcers is thought to be highly informative and reliable. It should not be followed by repeated roentgenological examinations, so it decreases the X-ray load both on the patients and on medical personnel and allows the optimal methods of treatment of patients with chronic gastroduodenal ulcers to be chosen.

Adult↗