[Lymphography in primary lymphooedema of the leg in children. With reference to seven lymphographies].
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Adolescent↗
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[Lymphography for prostatic carcinoma. 1. Results of leg lymphography].
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Aged↗
[The unilateral re-lymphography on the first day of accumulation. A contribution to the capacity of accumulation of the lymph-node following lymphography (author's transl)].
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Contrast Media↗
Lymphography as a guide to prognosis in malignant testicular tumours.
Lymphography was performed in 130 patients with malignant neoplasm of the testes. The patients were treated by irradiation, supplemented by chemotherapy when lymph node metastases were present. The survival rates of the various pathologic subdivisions were analyzed according to the lymphography. The following 5-year survival rates were observed: seminoma: normal lymphography 94%, pathologic lymphography 69%; teratocarcinoma: normal lymphography 86%, pathologic lymphography 14%; embryonal carcinoma: normal lymphography 64%, pathologic lymphography 33%.
Adolescent↗
[Reliability and value of diagnostic lymphography in carcinoma of the sigmoid, rectum and anus (author's transl)].
From 1963 to 1973, 253 patients with cancer of the sigmoid, rectum and anus underwent diagnostic lymphography at the Istituto Nazionale Tumori of Milan. In 218 patients lymphography was performed as part of the intial diagnostic work-up, while in 35 it was done during the follow up period, after surgery. The accuracy of radio-histological correlation was 95%. This confirms the reliability of diagnostic lymphography and its clinical usefulness. In view of these results, this diagnostic tool is essential in the initial evaluation in patients with carcinoma of the anus, because lymphography was superior (28%) to the clinical inspection (6%) in the evaluation of the inguino-iliac lymph nodes. Lymphography is also useful in rectal cancer since it permits, in case of nodal metastases, selection of a group of patients in whom the therapeutic program should be revised. The exam is useless in cancer of the sigmoid. In the small group of patients who had lymphography in the follow up period, this technique was the only to show, in symptomatic patients, the presence of pelvic and/or para-aortic nodal metastases. Lymphography is also useful in these patients for the evaluation of the results of the radio/chemotherapy on involved nodes.
Anus Neoplasms↗
[Study of the retroperitoneal lymphatic spread of müllerian ovarian carcinoma, using lymphography].
From January 1973 to May 1974, 117 patients with ovarian carcinomas were evaluated with lymphography. The tumors were staged and classified histopathologically according to FIGO (1971). Considering all cases, lymphography showed nodal metastases in 44 patients (38%). Lymphography was positive in 36% of serous cystoadenocarcinomas, in 26% of mucinous cystoadenocarcinomas, in 15% of endometrioid carcinomas and in 36% of unclassified carcinomas. Of the 10 cases not identified by cell type, lymphography was positive in 40% of cases. In 68% of cases bilateral involvement was found. The site of metastatic nodes was in 32% of cases only in the iliac chains were both involved. Considering the single node chains we found 36% of para-aortic, 27% of common iliac, 35% of external iliac and 2% of inguinal involvement. Metastases were observed, regardless of histological type, in 25% of cases in stage III, 62% iin stage IV, 54% in recurrences and only in 5% of cases in stage I. Therefore the lymphatic spread seems to occur in more advanced stages and in recurrences. In 28 of 117 patients node biopsy was performed. Histological-lymphographic correlation was correct in 7/7 positive cases and in 19/21 negative cases (93%). These results show that lymphography is a reliable tool in the evaluation of ovarian cancer.
Adenocarcinoma↗
Role of lymphography in management of filarial chyluria.
1. One hundred patients with chyluria were studied with lymphography and 80 cases were followed up for a period varying between six months to two and one half years. 2. There was preponderance of left sided lesions. The site of fistulations were mostly in the region of pelvis and calyces of the kidney. 3. It was observed that lymphography was very useful in treatment of chyluria. Thirty-eight patients (48%) with chyluria were completely free from symptoms and after lymphography, 23 (28%) of them had relief and 19 (24%) of the patients did not have any beneficial effect after lymphography. This procedure was of great help in demonstrating the site of fistulations which could be surgically corrected, in certain situations. 4. Lymphographic appearances of thoracic duct was helpful in deciding the operation of thoracic duct jugular vein anastomosis in some cases. 5. Lymphatico venous anastomosis was done in 3 patients at the root of the scrotum in whom retrograde flow of contrast material occurred into the testicular lymphatics on lymphography.
Chyle↗
[The value of lymphography as supplemental examination in thoracic diseases (author's transl)].
A literature review about the significance and incidence of lymphography in intrathoracic diseases (lymphogranulomatosis, reticulum cell sarcoma, lymphosarcoma, chronic lymphatic leukemia, giant follicular lymphoma, pulmonary sarcoidosis) is given. Intrathoracic manifestations of malignant lymphomas are absolute indications for lymphography. With the proof of retroperitoneal lymph node involvement alterations in staging of the disease and therapeutical consequences are emerging. In benign lymph node diseases, such as pulmonary sarcoidosis, lymphography will be also helpful for staging, but therapeutic consequences do not ensue, an absolute indication for lymphography is not validated. Lymphography is valuable for the diagnosis of diseases and injuries of the thoracic duct. The existing methods of lymphographic visualization of intrathoracic lymph nodes are not yet satisfying and need further research.
Hodgkin Disease↗
[Vulvar neoplasms and preoperative lymphography].
20 patients with histologically verified carcinoma of the vulva fulfilled the following conditions: general operability, preoperative lymphography, radical vulvectomy with inguinal lymph node resection and histological examination of all lymph nodes. It was studied how far the preoperative lymphography plays a role for the strategy of operative treatment of carcinoma of the vulva and eventually in the limitation of risks of operative treatment. A survey of the lymphatic drainage of the vulva underlines the importance of the knowledge of the lymphatic pathways for the operation and for the lymphography as performed in this hospital since 1972. The results suggest that lymphography shows an unacceptable high number of false-negative results in cases of metastatic involvement of the inguinal nodes (7 out of 10 cases), whereas it is reliable for the judgment of the iliac and paraaortal nodes. For this reason the resection of the inguinal nodes remains a necessary part of radical vulvectomy. The additional removal of intrapelvic lymph nodes has been restricted to patients with lymphographic signs of positive nodes. In our opinion preoperative lymphography is of considerable value to minimize the operative risk for patients with carcinoma of the vulva by means of a more precise preoperative diagnosis, stage-oriented therapy and postoperative control.
Aged↗
[The importance of the results of pretreatment pelvic lymphographies in the prognosis of carcinomas of the uterine cervix. A critical evaluation of the proposal to classify these tumors according to the TNM system (author's transl)].
Between 1966 and 1969, 494 patients with carcinoma of the uterine cervix stages I a to IV were admitted in our hospital for primary treatment. In 420 of these patients with carcinoma of the cervix stage I b to IV, complete results of bilateral pretreatment pelvic lymphography are available. The correlation between the results of the lymphographies, the choice of the operative treatment and the cure rates in these 420 cases are reported. All the correlations between the results of the pretreatment lymphography and the prognosis are described. A positive lymphography was in our series of high prognostic value. A plea is therefore made to include the results of the pretreatment lymphography into the classification of carcinoma of the cervix. Classification of the carcinoma of the cervix into the TNM categories is desirable. Our series is reported in these TNM categories. The advantages of such classification are described. The morbid entity of carcinoma of the cervix becomes more transparent to the observer and the choice of operative therapy becomes easier. The prognosis is more clearly established. The proposals of the TNM committee of the UICC for the classification of carcinoma of the cervix according to the TNM categories and the staging according to these categories are discussed critically.
Female↗
The value of sonography and lymphography in the detection of retroperitoneal metastases in testicular tumors.
Lymphography has led to falsely negative or falsely positive diagnoses in 10 to 45 per cent of the cases of testicular tumor metastases reported in the literature. In our comparative study of lymphography and sonography in the preoperative staging of 29 malignant testicular tumors lymphography was accurate in 58.5 per cent of the cases, while sonography had an accuracy rate of 82.5 per cent. Sonography was superior to lymphography in the evaluation of hilar lymph node metastases and their extent, as well as for routine checkups after lymphadenectomy or irradiation.
Adult↗
[Indirect lymphography of the thyroid gland. 2].
Indirect lymphography of the thyroid gland was performed in 144 patients. A conclusion was drawn that the use of superfluid oil contrast preparations of lipidol, miodyl type etc. in indirect lymphography of the thyroid gland will permit to obtain the exhaustive information on the state of the endocrine organ and regional lymph nodes. Lymphography with the aid of oil contrast preparation iodolipol diluted with ether and heated to the body temperature is less informative; water-soluble contrast agents were less effective. All the test contrast agents proved to be ineffective for detection of changes in the lymph nodes. Use of iodolipol for lymphography of the thyroid gland without preliminary mixture with ether is not recommended.
Adolescent↗
Current status of lymphography in patients with cancer.
In the early 1960's lymphography was received enthusiastically. Expectations were high that a very accurate diagnostic method for the detection of metastases had been found. This enthusiasm subsided after it became apparent that small lesions could not be discerned and that the images demonstrated were frequently nonspecific. Better correlation was achieved with advanced stages of cancer but because the presence of metastases was usually already known, it was questionable if the lymphogram contributed much to the management of the patient. In recent years, after the examination was placed in its proper prospective, the value and status of lymphography in patients with cancer were reassessed. The radiographic findings were divided into direct, or actual demonstration of metastastases, and indirect changes--those changes resulting from replacement of lymph nodes or blockage of the vessels by metastases. Lymphography proved particularly valuable in the diagnosis and staging of patients with pelvic cancer arising from such organs as cervix, uterus, vulva, ovary, and from tumors arising from the prostate, testicles, and penis. It also proved valuable in the assessment of extension of disease in melanomas of the extremities. The value of the positive lymphogram is easy to assess. However, when one encounters a "normal" lymphogram, one must realize that this does not exclude the presence of metastatic disease; it merely demonstrates that the the time of the study no lesions were recognized in visualized lymph nodes. Therefore, the negative lymphogram should not result in any modification of treatment which would have been prescribed under the same clinical circumstances if one did not have the lymphogram at hand.
Female↗
A comparative study between direct testicular and pedal lymphography in dogs. (A preliminary report).
In 20 dogs, 12 bilateral and 8 unilateral pedal and direct testicular lymphographies were performed. Comparison between the two methods showed that pedal lymphography failed to visualize some of the regional lymph nodes of the testicle. Histological examinations of the excised testicles two months after the injection of the contrast material failed to show any significant abnormalities. The potential applications of direct testicular lymphography are discussed.
Animals↗
A review of the role of lymphography in the management of testicular tumours.
The pedal lymphographic findings in 260 patients with testicular tumours are reviewed: 117 patients had a seminoma, 105 had a teratoma and 38 combined tumours. 26 percent of seminomas were associated with a positive lymphogram, corresponding figures being 42 percent for teratomas and 53 percent for combined tumours. The role of the lymphogram is (1) to stage the case so that the extent and form of the treatment can be logically assessed, (2) to plan accurately radiotherapy treatment fields, (3) to observe the results of treatment on serial follow-up films, (4) to detect the recurrence of tumour using "re-fill" lymphography if necessary, (5) to show possible unsuspected metastases involving supraclavicular and mediastinal glands, and (6) to give a prognosis, since a negative lymphogram suggests an excellent chance of survival. Three main types of lymphographic appearances are recognized: nodal, mass replacement and "pseudo-lymphomatous". Nodal deposits are most common. Most positive findings are in the para-aortic chain on the same side as the tumour. Iliac involvement is much less common. Seminomas in this series showed a 96 percent crude three-year survival rate. For teratomas and combined tumours the three-year survival rates were 59 percent and 61 percent respectively, but deaths are uncommon in the lymphographically negative Stage I cases. Bone deposits are rare. Only two were found in this series. We do not perform testicular lymphography, but consider there is a useful role for inferior venacavography when there is poor filling of upper para-aortic nodes at lymphography. The importance of taking follow-up films after the initial examination is stressed.
Bone Neoplasms↗
The diagnostic accuracy of lymphography in Hodgkin's disease (author's transl).
Between 1972 and 1975, exploratory laparotomies were carried out on 52 otherwise untreated patients with histologically verified Hodgkin's disease in stages I, II and III following lymphography. 84% of patients with negative lymphograms had histologically normal lymph nodes. 16% of negative lymphograms were shown to have to have histologically positive lymph nodes. Two out of eight patients diagnosed as positive on lymphography (25%) proved to be false positives caused by extensive lymph node involution. The diagnostic accuracy lymphography was therefore 83%. Surgical exploration was of value only in histologically positive cases. Post-operative control by means of lymphanigiography is essential for the evaluation of the course of Hodgkin's disease.
Adolescent↗
[Lymph node metastases--diagnosis by lymphography and CT (author's transl)].
The value of lymphography and CT in the diagnosis of abdominal lymph node metastases was compared in 82 patients with various types of malignant disease. In the presence of systemic disease or testicular tumours, CT increased the recognition of lymph node metastases and their extent, particularly of high para-aortic deposits which were frequently underestimated by lymphography. Lymph nodes in the pelvis are more easily identified. CT is the first choice for the investigation of systemic disease and testicular tumours. This will, in addition, also demonstrate abnormalities of the organs and assist in radiation planning. CT is a simple procedure which is also very valuable in following the effect of treatment. For metastases from other origins, lymphography is often more valuable since CT is unable to identify metastases in lymph nodes if these are not enlarged. The two methods complement each other and their combination provides improved diagnostic information.
Carcinoma, Squamous Cell↗
[A new contrast medium emulsion for lymphography (author's transl)].
A new contrast medium for lymphography has been developed. It is suitable for direct, such as bi-pedal, lymphangiography, and has certain advantages compared with the commercially available contrast medium Ethiodol, such as absence of a lipogranulomatous reaction and less extensive oil emboli in the lungs. It is also possible to use the substance for indirect, retrosternal lymphography. The substance is indirect, retrosternal lymphography. The substance is an emulsion of triglycerides of iodinated poppy seed oil. The method of preparation of the emulsion is described.
Animals↗