Lymphangiography in the Evaluation and Treatment of Testicular Tumors

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LYMPHANGIOGRAPHY has only recently become of great value in diagnosing and in treating certain diseases. It has not been in widespread use partly because the procedure is slow and tedious, the lymph vessels being small and containing only a small amount of colorless fluid. In 1955, Kinmonth, Taylor, and Harper1 reported a method whereby a lymph vessel can be identified after the subcutaneous injection of a vital blue dye, so that when radiopaque material is injected directly it will outline the vascular course, the branches, and the regional lymph nodes. Their method has become a useful means of studying regional edema and primary and secondary neoplasms of lymphatics and lymph nodes by the recognition of an abnormal pattern of lymph node anatomy. Several applications of this procedure to urologic problems have been reported.2,3 The purpose of our paper is to show how lymphangiography has been used in the evaluation and treatment of patients with metastatic testicular tumors.


The technic for lymphangiography, devised by Kinmonth, Taylor, and Harper,1 was modified slightly by Wallace and associates,2,3 and is as follows. First, the surface of the foot to be injected is suitably cleansed, after which, 0.5 ml. of a 1 to 1 mixture of 0.5 per cent Evans Blue Dye and 1 per cent procaine hydrochloride is injected intradermally in the web between the first and second digits of the foot. (Other satisfactory vital dyes are Alphazurine 2 G and Direct Sky Blue§.) About 30 minutes later an incision is made on . . .



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