Lymphatic evaluation can help diagnose chyluria through a non-invasive scan using Tc99m sulfur colloid. The study evaluated 4 patients, finding chyle efflux from the ureteric orifices in 3 who tested positive for chyluria. While cystoscopy remains the gold standard, lymphatic scanning is easy, effective, and correlated well with cystoscopy findings in diagnosing the source of chyluria.

2. LYMPHOSCINTIGRAPHIC
EVALUATION IN CHYLURIA
Dr V Sivasubramaniyan
Dept. of Nuclear Medicine
*
Dr H S Bhat
Dept. of Urology
*
SRI SATHYA SAI INSTITUTE OF
HIGHER MEDICAL SCIENCES -
PUTTAPARTHI

3. AIMS
 TO HIGHLIGHT THE UTILITY.
 TO ANALYZE ADVANTAGES.
 CORRELATION WITH CYSTOSCOPY.

4. METHODOLOGY
• Radiopharmaceutical – Tc99 m Sulphur
Colloid.
• Dose : 2 mCi . Route : Subcutaneous.
• Protocol : Whole body acquisition.
• Instrumentation : DIACAM single-head
Gamma camera.

5. Study population
Number Age gp Mean age
(Yrs) (Yrs)
Male 3 40-60 50.0 +/- 5.8
Females 1 16

6. • 42 / M C/O passing turbid urine
– 6 yrs.
• Urine AFB positive. Put on ATT.
• Urine analysis : Chyluria positive.
• Cysto : Bladder full of chyle. Both
ureteral orifices show eflux.

10. • 48 / M C/O haematochyluria on and off
– 2 months.
• Urine AFB negative.
• Urine analysis : Chyluria positive.
• Cysto : Left ureteric orifice showed chyle
eflux.

13. • 60 / M C/O Passing turbid urine & clots
– 2 months.
• Urine AFB negative.
• Urine analysis : Chyluria positive.
• Cysto : Bladder full of chyle.

16. • 16 / F C/O persistent right loin
pain.
• Had Rt lymphatico-renal
disconnection in 1998.
• Urine analysis : Chyluria negative.
• Cysto : Not done.

19. CONCLUSION
• Totally non invasive study.
• Easy, effective and simple.
• Correlates well with
cystoscopy.