Postlymphangiogram Film as an Indicator of Tumor Activity in Lymphoma

Abstract

Analysis of postlymphangiogram films demonstrates a slight but definite increase in the size of normal lymph nodes following lymphangiography, with a gradual decrease in size subsequently. Contrast material is lost from the nodes in greatest quantity during the first month and then more gradually during succeeding months. Adequate contrast material remains in the nodes for 6 to 34 months. In 70% of patients there is enough contrast material in the nodes one year after lymphangiography to permit assessement of change in size or appearance. The lymphanglographic signals of new or recurrent lymph node involvement are the following: (1) development of the typical lymphoma pattern; (2) sustained increase in size; (3) central filling defect, increasing in size; (4) displacement or separation of nodes. With these criteria, late films showed evidence of new or progressive disease in 21% of 100 patients with lymphoma studied consecutively by lymphangiography. Thus, the postlymphangiogram follow-up film is a simple and inexpensive method which frequently affords information unavailable by other techniques. Possible pitfalls in interpretation are discussed.