The Cinical Application of Lymphography in Genital Cancer

• Published in: Japanese Journal of National Medical Services Vol. 20; no. 3; pp. 217 - 229
• Main Authors: UCHIDA, Hideo, MORI, Sigeru, SAKIHARA, Yoshiko, TANAKA, Tsuyoshi, TAKEDA, Yoshinori, OKAMOTO, Sunao, NAKAGAWA, Hyosuke, KIRIMOTO, Koji
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 1966
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.20.217

The lymphographic study was made on 70 cases of genital cancer. The results of pathologic studies on 33 patients who had lymphadenectomy and post mortem studies were exactly correlated with the lymphographic findings. Metastatic changes of lymph nodes were verified by histologic examination in 8 cases, the lymphograms of which were estimated as positive for metastatic involvement. The histology of the rest of them (25 cases) had no metastatic changes but these lymphograms revealed various findings suspectable of pathological changes. n the other 37 cases which were clinically but not histologically proved of metastatic changes of lymph nodes, variable similar findings were also obseved on lymphograms. In the cases with metastatic involvement of lymph nodes, the characteristic malignant patterns such as filling defects, irregular contour and inhomogenous artitecture were noted, moreover, an increase in number and size were observed. These findings are frequently found in inflammatory process. In the lymphatic system with extensive involvement, however, passage disturbance is often found with changes of lymph vessels such as dilataton, tortuosity. back flow, collateral, detour, oozing and an increase or decrease in number. False positive findings of lymph nodes, resulted from inflammation, fibrous fatty deposit or ococcasional super imposition of lymph nodes are frequently encountered. Because the postoperative lymphogram reveals so variable that it is difficult to diagnose whether these patterns depend on lymphadectomy or reccurrence and also hard to investigate the etiology of secondary edema, the differentiation of these patterns have to be made by both lymphography and venography. Lymphography was usually performed prior to radical operation as a guide for nodal dissection, to search the gross metastatic extent of genital cancer and at the same time the application of PTCHLO (pure natural chlorophyll oil) with oily contrast medium (Ethiodol or Poiodol) made it easier for gynecologist to identify lymph nodes at the operating table. Controverting the some authors, the obturator in most cases, the hypogastric in more than a half, and sometimes the cardinal ligament and the sacral lymph nodes were greenly stained. In setting up the portals for radiation therapy, lymphography was beneficial to place various portals and recently we adopted a diamond-shaped field (12×12cm-14×14cm). Postlymphographic complications were observed in high incidence, these were pulmonary embolism, fever chillness, inappetence, fatigue, cough and sputum. Although microscopic metastatic lesions were usually not detectable by this technique, the lymphography is to be said a nssesary procedure to examine malignant tumors, especially lymphatic tumors showing certain specific features.