lymphangiographic features

Last reviewed 01/2018

Lymphangiography may be more revealing than the clinical picture. Major features may include:

  • lymphatic hypoplasia - present in 90% of cases; usually involving distal rather than proximal lymphatics

  • lymphatic hyperplasia - unilateral or bilateral - in about 10% of cases

  • retrograde obliteration - the main vessels become obstructed distally - attributed to 'die-back' of overloaded lymph nodes

  • chylous reflux - backflow of chyle from cysterna chyli with dilated lymphatics producing chylous vesicles and fistulae on the limbs

Lymphangosyntigraphy now has replaced lymphangiography as the investigation of choice.(Due to the associated problems like scarring and atrophy which may affect the remaining lymphatic vessels) (1).

Lymphangosyntigraphy is useful in:

  • diagnosing oedema in patients without any recognized risk factors
  • differentiating lymphedema from non lymphatic causes of oedema (1).

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