Investigations of lymphatics

  • 576 views
Uploaded on

 

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
576
On Slideshare
0
From Embeds
0
Number of Embeds
0

Actions

Shares
Downloads
22
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. By Kareem Hamimy 6 th year Medical Student Kasr al Ainy Medical School
  • 2.
    • Usually Clinical is enough
    • If typical, mild, no complicaions,
      • No Need for investigations
    • If atypical, Multifactorial Swelling
      • Help to confirm
      • Inform management
      • Provide prognostic information
  • 3.
    • Full blood count
    • Blood Sugar level
    • Urea and electrolytes
    • Creatinine
    • Liver, thyroid function tests
    • Chest x-ray
    • Urine dipstick (chyluria)
    • Blood smear (microfilaria)
  • 4. Direct Indirect
  • 5.
    • Principle ?? (Dye-Inject- Oily- PLV-contrast-Radiographic)
    • Was Gold Stndard, Now Obsolete (why ?)
        • Surgical exposure
        • Damage to the lymphatic endothelium by oil
        • Pulmonary oil embolism
        • Wound infection
    • Used in Few Cases
        • Preoperative MegaLymphatics considered for bypass or fistula ligation
  • 6.
    • Principle?? ( Inject- Intradermal- nonionic contrast- Radiographic)
    • Shows the Distal lyphatics but not normally proximal lymphatics
  • 7.  
  • 8.
    • Gold Standard Now
    • Principle ?? ( Radioactive technitium ptn – colloid particles- interdigital Webspaces- serial radiograph gamma camera
    • high-resolution imaging of peripheral lymphatic vessels
    • provides insight into lymph flow dynamics.
    • helps evaluate lymphatic truncal anatomy and radiotracer transport.
    • It can also be used to evaluate the efficacy of various treatment options designed to facilitate lymph flow or reduce lymph formation.
  • 9.
    • The procedure is essentially noninvasive, can easily be repeated, and does not adversely affect the lymphatic vascular endothelium.
  • 10. Arms Legs
  • 11.
    • Axial Computerised tomography
    • To Exclude Tumours Causing Edema
    • Also lymphedema can appear in CT ( As Coarse, non enhancing, reticular, honey comb pattern in an enlarged subcutaneous compartment)
  • 12.
    • Magnetic resonance Imaging
    • Clear Images of lymphatic Channels and lymph nodes
    • Useful in pts with lymphatic hyperplasia
    • Distinguish between Venous and lymphatic
    • shows tumours causing obstructions
    • Expensive
  • 13.
    • Shows venous abnormality
    • For Filariasis
  • 14.
    • Where Malignancy is suspected
    • Lymph node biopsy
    • Skin Biopsy where lymphangiosarcoma is suspected
  • 15.  
  • 16.  
  • 17.  
  • 18.  
  • 19.  
  • 20.  
  • 21.
    • Right leg lymphedema and groin mass in a 72-year-old man.
    • Clinical photograph shows marked enlargement of the right leg.
    • Presurgical lymphangioscintigrams obtained 35 minutes (left) and 4½ hours (right) after injection of radiotracer demonstrate prominent dermal backflow in the right leg with intact trunks superiorly, findings that are suggestive of secondary lymphedema
    • CT, MRI Showing Cystic mass very near to the Hip Joint
    • Clinical photograph taken 6 weeks after excision of a large synovial cyst demonstrates resolution of overt edema
  • 22.
    • Bailey and Love: Short Practice of Surgery
    • http://radiographics.rsna.org/content/20/6/1697.full
  • 23.