The lymphangiogram provides information about the internal organization of the lymph nodes in the pelvis and the back of the abdomen.

The test is not often done now in the diagnosis or staging of lymphoma. The CT scan , the gallium scan, or the MRI or PET scans may be used instead. This test was favored by some institutions over the last 30 years including Stanford University.

The test is performed by injecting a dye or contrast agent into the lymphatic vessels of the foot (if both feet are used, which is common, this test is called a bipedal lymphangiogram). The lymph vessels in the feet drain into the lymph node in the back of the abdomen.

Patient Preparation:

Informed consent is obtained from the patient. There are no dietary restrictions. The patient should receive a teaching booklet detailing the procedure and instructions for preparation (some institutions are better than others in this regard).

The Procedure:

A local anesthetic is usually used to numb the area between the first and second toe on each foot. An incision is made, and a small needle placed in the lymph vessel.

The dye is often blue in color and very thick. The infusion into the lymph system is very slow. The patient must lie very still, often for 4-7 hours. The dye may be uncomfortable or cause a mild burning sensation.

After the dye has sufficiently permeated the lymph system, the initial x-rays are taken. The incisions are then closed (the patient should ask medical staff for additional anesthetic if it has worn off).

Aftercare:

Dressings are placed on the incision sites. Lying on a table for many hours may make the patient stiff - given the stiffness and the discomfort of the procedure the patient should probably have assistance getting home. The patient should be informed that their urine will have a blue-green color for several days. Walking may be uncomfortable for up to a week. Often patients refer to their feet as "Smurf Feet" until the dye fades. Some patients report flu-like symptoms the day after.

(Lymphangiogram IMAGE)
Lymphangiogram image by The University of Michigan Medical School with permission

How Long Does the Dye Last?

The dye is retained in the lymph fluid anywhere from 6 months to 2 years, which enables doctors to evaluate the status of the lymph nodes easily throughout treatment with a simple abdominal x-ray.

 

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Resources

Yahoo Health: Lymphangiogram
Cornell - Description of Lymphangiogram
Univ. of Michigan - Lymphangiogram Image

 

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