A Critical Evaluation of Lymphangiography

Lymphedema and Lymphography in Sarcoidosis

“…This radiological picture resembles that found in lymphoma. Such occasional lymphographic similarity between sarcoidosis and lymphoma has been previously noted by Schaffer et al 3 Thus, in addition to the obvious indication in patients with unexplained swollen lower extremities, patients with puzzling problems of abdominal pain, fever, or ascites, might also be candidates for lymphography if more routine diagnostic measures short of laparotomy are negative. The demonstration of the type of lymph-node abnormality shown in our case should then be followed by biopsy in order to establish with certainty the exact pathological cause for the observed defects.…”

“…Laboratory findings at this time were : hemo¬ globin 11.2 gm/100 ml, red blood cell count (RBC) 4.1 million/cu mm, segmented neutrophils 54%, eosinophils 4%, basophils 1%, lymphocytes 39%, and monocytes 2%, total protein 7.0 gm/100 ml, albumin 3.3 gm/100 ml, globulin 3 be 60.2%, -globulin 3.6%, ««-globulin 6.1%, /3-globulin 11.2%, and -globulin 18.8%. Chest x-ray findings were negative.…”

Pitfalls in the diagnosis of metastatic carcinoma

“…Although a prospective study has not been reported a t this institution, we suspect t h a t the reliability of lymphangiograms in solid tumors is quite low and we question the utility of this technique in the evaluation of patients with solid tumors. The impression t h a t lymphangiography is frequently beset with both false-positive and false-negative findings in patients with carcinoma is shared by other investigators (Koehler et al, 1964;Lee and Martin, 1966;&Peak and Constantinides, 1964;Schaffer et al, 1963 ;Viamonte et al, 1962). Even in the evaluation of patients with Hodgkins' disease and other lymphomas in which it has been claimed t h a t the accuracy of lymphangiography approaches SO%, recent studies b y Glatstein et al (1969) have shown t h a t in patients with clearly negative bilateral lower extremity lymphangiograms approximately 18% of those subjected to laparotomy may be found to have some evidence of lymph node involvement.…”

Primary lymphoedema: Clinical and lymphangiography studies

“…The exact role of lymphaticovenous communications is difficult to assess at present. They have been demonstrated in the presence of neoplastic involvement (Schaffer, Kochler, Daniel, Wohl, Rivera, Meyers, and Skelley, 1963) and in this situation they probably avert clinical lymphoedema in some cases. Their presence may well explain the variable incidence of secondary lymphoedema of the arm following radical mastectomy and irradiation of the axilla.…”