Lymphangiogram

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Lymphatic drainage

Lymphatic system

A lymphangiogram is a special x-ray of the lymph nodes and lymph vessels. Lymph nodes produce white blood cell (lymphocytes) that help fight infections. The lymph nodes also filter and trap cancer cells.

The lymph nodes and vessels are not usually seen on a normal x-ray, so a dye or radioisotope (radioactive compound) is injected into the body to highlight the lymphatic areas.

Lymphography; Lymphangiography

The test is performed in a hospital radiology department or in the health care provider's office.

If leg or arm swelling is being evaluated, you may be offered a sedative to help relax. You will be put in a specially constructed chair or on the x-ray table. The skin of each foot is cleansed, and a small amount of blue dye is injected between the toes into the webbing.

Within 15 minutes, thin, bluish lines appear on the top of the foot. This identifies the lymphatics. Then, a local anesthetic is given and a small incision is made into one of the larger blue lines. A needle or catheter (a thin flexible tube) is inserted into a lymphatic channel in each foot, and a contrast medium is injected into each foot at a very slow rate (60 to 90 minutes for all the contrast medium to be injected).

A fluoroscope (a special x-ray machine that projects the images on a TV monitor) is used to follow the dye as it spreads through the lymphatic system up the legs, into the groin, and along the back of the abdominal cavity.

Once the contrast medium is injected, the catheter is removed, and the incisions are stitched and bandaged. X-rays are taken of the legs, pelvis, abdomen, and chest areas. The next day, another set of x-rays may be taken.

If a site of cancer (breast or melanoma) is being studied to evaluate spreading, a mixture of blue dye and a radioactive tracer is injected next to the mass. Special cameras detect the spread of tracer along lymph channels to outlying nodes.

During a biopsy, a blue dye or radioactive substance helps the surgeon see nearby areas (such as the arm pit for breast cancer) The dye or radioactivity can reveal the way the cancer has spread.