リンパ系造影法に関する研究(第1報)

Lymphographic studies have been performed on 67 patients since December, 1963. Approximately two third of patients had carcinoma of the stomach, rectum and breast, malignant lymphoma and swollen limbs. Our lymphographic studies were based on the Kinmonth's method with minor modification.<br>We reported nine interested patients. They were as follows:<br>Patient 1: A 61 year old man was hospitalized with carcinoma of the stomach and carcinomatous peritonitis after gastrectomy. Bilateral lower limb lymphographic studies disclosed moth-eaten appearances in the para-aortic lymph nodes and persistence of the contrast material in the cisterna chyli.<br>Patient 2: A 37 year old man was admitted to our hospital with carcinoma of the rectum. As the radical resection was impossible, an artificial anus was made. Bilateral lower limb lymphographic studies revealed enlargement of both subinguinal superficial, external iliac and common iliac nodes and irregular filling defect of the large right Rosen-Müller's node.<br>Patient 3: A 46 year old man received resection and anastomosis of the small intestine for cancer of the small intestine. Bilateral lower limb lymphograms showed that abdominoaortic vessels increased in numbers and sizes and reflux of contrast material into the left iliac wing collateral.<br>Patient 4: A 69 year old female was diagnosed as having carcinoma of the cecum, for which ileocolostomy was performed.<br>Bilateral lower limb lymphographic studies revealed ghostlike appearances as secondary evidences of metastatic lesions in the right para-aortic area and enlargement of the paraaortic nodes.<br>Patients 5: A 48 year old female was hospitalized with carcinoma of the left breast. Left upper limb lymphograms showed lateral and central axillar, pectoral, infraclavicular and inferior profundal cervical nodes increased in numbers and sizes.<br>Patient 6: A 60 year old man had carcinoma of the rectum. His lymphograms showed moth-eaten appearances in the Virchow's lymph nodes.<br>Patient 7: A 55 year old man was admitted to our hospital with malignant lymphoma of both axillary and supraclavicular area. Bilateral lower limb lymphograms demonstratedd lacy appearances of both large abdomino-aortic, common iliac and external iliac nodes. The tumors were irradiated with use of the tele cobalt unit by way of eight ports. A total of 17050 r in air was given over the tumors for 102 days. The lymphograms disclosed apparently reduced size 3 of tumors. The patient tolerated this therapy well with goodd subjective response.<br>Patient 8: A 12 year old girl had a one year history of swelling of the left lower limb with unknown cause. The left lower limb lymphograms demonstrated the marked increase in numbers, sizes, tortuousities, collateralizations, dermal backflows of lymphatics in the left lower limb.<br>Patient 9: A 53 year old female received total removal of the uterus for carcinoma of the uterus. After bilateral lower limb lymphographies, the oil embolism occured in both lungs. Immediate film of the chest showed generalized small punctate densities throughout both lungs, with reticular patterns in the magnified view of the right lateral upper area.<br>The moth-eaten apperance was only seen in the lymphogram of patient with advanced carcinoma. It was important finding to increase in numbers and sizes of lymph nodes what were impossible to differentiate from inflammatory nodes before becoming filling defects.<br>In such a case showing a ghost-like appearance, it was very important to compare immediate films with twenty-four-hour films.<br>Photomicrograph of lymph node with reactive lymphadenitis after injection of contrast material showed many clear spaces in its parenchyma, but photomicrograph of lymph node with carcinomatous metastasis demonstrated almost no clear spaces in the carcinomatous tissues. It seemed that contrast materials were seen as clear spaces. Therefore the carcinomatous lymph tissue area was demonstrated as a f