Lymphangiogram

To help determine if cancer has spread to the lymph nodes and lymph vessels your oncologist may order a lymphangiogram. The lymph nodes and vessels are not usually seen on a normal x-ray, so a dye or radioactive compound is injected into the nodes. X-rays are taken to see if there are any blockages indicating the presence of cancer.
 
What to expect
The test is performed as an outpatient procedure in a hospital radiology department, one of our outpatient facilities or in the oncologist's office.
 
Before the test
You'll be given instructions before your appointment.
  • Do not eat or drink for several hours before the test
  • Arrive early for your test because you will need to fill out paperwork
  • Bring identification and your insurance information
  • You'll be asked about bleeding problems or any allergic reactions to x-ray contrast material or iodine containing substances
  • You may be offered a sedative to help you relax
  • You'll be put in a special chair or on an x-ray table.
 
The test
If the site of a cancer tumor is being studied to evaluate spreading, a mixture of blue dye and a radioactive tracer is injected next to the tumor; otherwise the dye is injected into your feet. When the dye is injected into the feet, here's what you can expect:
  • The skin of each foot is cleansed and sterilized.
  • A small amount of blue dye is injected between the toes into the webbing.
  • After 15 minutes, the technician will look for bluish lines that should begin to appear on the top of the foot. This defines the lymphatics.
  • You'll be given a local anesthetic.
  • A small incision is made into one of the larger blue lines.
  • A needle or catheter is inserted into a lymphatic channel in each foot.
  • A contrast dye is injected into each foot at a very slow rate, in most cases about 60-90 minutes. There may be a feeling of pressure as the contrast dye is injected, and there may be some discomfort behind the knees and in the groin area.
  • A special x-ray machine called a fluoroscope projects the images on a TV monitor as it follows the dye.
  • As the dye spreads through the lymphatic system up the legs, into the groin, and along the back of the abdominal cavity, images are projected on the monitor.
  • Special cameras detect the spread of the dye and tracer along the lymph channels to outlying nodes.
  • Once the contrast dye has been completely injected, the catheter is removed and the incisions are stitched and bandaged.
  • X-rays are taken of the legs, pelvis, abdomen, and chest areas.
  • You may be asked to return the next day for another set of x-rays.
 
Recovery
Once you are home you can expect that:
  • The incision site will be sore for a few days. 
  • The blue dye will color the urine and stool for about 48 hours.
  • Your skin and possibly vision will take on a bluish cast temporarily.

 

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