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Lymphography rad 205-2013
1. Lymphography
Lymphography: Lymph/o: Lymph /
-graphy:………
Invasive procedure
Oil base contrast (the radiographic one)
Uses gross-visualized dye contrast and
radiopaque contrast
Lymphogram is the term used to cover
both lymph vessels and lymph nodes’
studies: lymphangiography and
lymphadenography
2. Basics of the Lymphatic System
Returns proteins and fluid that has leaked out of the
bloodstream back into the blood
Relates to the immune system. Lymphocytes and
monocytes
The Lymphatic system is divided in lymph nodes,
lymph vessels and lymph capillaries
3. Lymph Nodes
Most common and largest clusters of lymph nodes:
Cervical
Axillary
Mediastinal
And inguinal (groin)
Note: tonsils are masses of lymph
tissue.
Note: adenoids are enlarged lymph
tissue in the nasopharynx.
4. Procedur
e
A violet color dye is injected
subcutaneously between 1st
and 2nd
interdigital spaces,
foot or hand.
The dye works as a tracer to
find the lymph vessels
One incision is made on the
superior aspect of injected
foot, or posterior aspect of
the injected hand.
5. Procedure
The incision should be just big enough to access the
tinted lymph vessels (visualized thanks to the violet
dye)
The injection of radiographic oil-base contrast is
done trough the uncovered lymph vessels
The injection takes about 30 min. using a 27 or 30
gauge needle
6. Procedure
Confirmation of injection in the lymphatic system
could be done with fluoroscopy
The first radiograph is taken 1 hr after injection, to
visualize only lymph vessels
Lymph Nodes radiographs are taken 24 hrs after
injection.
Lymph nodes retain contrast for 3 to 4 weeks
7. Procedure
Abnormal physiology may retain contrast for months
Delayed films may be required
The violet coloration can be observed on skin and
urine and it usually disappear within a few hrs after
injection.
11. Alternative Exams and
Indications
MRI and CT have replaced this procedure almost
completely. However, lymphography is useful
evaluating extent of lymphomas and staging of
radiation. Also, demonstrating obstructions of lymph
vessels and others.
