I had one done at Jackson Memorial Hospital in Miami in 1966. The test showed I was missing significant inguinal lymph nodes. This was not particularly surprising since I was born with Milroy's Syndrome.
There were complications involving the dye used and subsequently the test was replaced. The dye stayed in the lymph nodes and lymph system for up to two years and a number of patients experienced increased complications with their lymphedema.
I want to stress that no one should be having a lymphangiogram done today.
See our page on lymphoscintigraphy.
This test is a specialized X-ray of the lymph nodes. It is not done so often now that CT scans and MRI scans can be used to check lymph nodes. But it may sometimes be necessary. You are most likely to have this test if you are being investigated for non-Hodgkin's lymphoma or Hodgkin's disease.
You can have a lymphangiogram of the lymph nodes in any part of the body. The test is done in the hospital X-ray department. It takes about 2-3 hours. It is not painful, but can be uncomfortable and tiring.
To show up the lymph nodes on the X-ray, a dye must be injected into the lymph vessels. This is usually done in the skin of the feet. A local anesthetic is injected first and then the dye. The dye travels through the lymphatic system and into the lymph nodes. Once the dye is in the lymph nodes, X-rays are taken. Any lymph nodes that contain cancer will show up as enlarged on the X-ray.
You may be asked to stay lying down for an hour or two after the test. You will probably be able to go home the same day.
You may have one or two side effects from the lymphangiogram. Your
Skin may look a slightly blue or green color Urine may look slightly blue or green These side effects are nothing to worry about and will disappear within 48 hours.
It can take time for test results to come through. How long will depend on why you are having the scan. Usually, the scan is examined by a specialist in radiography and a report typed up. The report is then sent to your specialist, who will then give the results to you.
A lymphangiogram is used to evaluate the possible spread of cancers and the effectiveness of cancer therapy. The X-rays may also help determine the cause of swelling in an arm or leg and check for parasitic diseases. The test is performed by injecting blue dye into an area to be tested. The blue dye helps to locate the lymphatic vessels where the catheter will be placed. Once the lymph vessels are found, contrast medium is injected through the catheter and X-rays are taken to monitor its progress as it spreads through the lymph system up the legs, into the groin, and along the back of the abdominal cavity. The next day, another set of X-rays is taken
Lymphography; Lymphangiography Definition Return to top
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.
How the Test is Performed
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.
How to Prepare for the Test
Inform the health care provider if you are pregnant or you have bleeding problems. Also mention if you've had allergic reactions to x-ray contrast material or any iodine-containing substance. You must sign a consent form. You may be asked to not eat or drink for several hours before the test. You may wish to empty your bladder just before the test.
If you are undergoing lymphangiography for sentinel lymph node biopsy (in breast cancer and melanoma), you will need to prepare for the operating room. A surgeon and anesthesiologist will discuss how to prepare for the procedure.
How the Test Will Feel
There will be a brief sting from the needle and blue dye injected between the toes. There is another brief sting with the injection of the local anesthetic. There may be a feeling of pressure as the contrast medium is injected, and there may be some discomfort behind the knees and in the groin area.
The incisions will be sore for a few days. The blue dye will color the urine and stool for about 48 hours. The skin and possibly the vision will take on a bluish cast temporarily.
Why the Test is Performed
A lymphangiogram is used with lymph node biopsy to determine the possible spread of cancer and the effectiveness of cancer therapy.
Contrast dye and x-rays are used to help determine the cause of swelling in an arm or leg and check for parasitic (organisms that live on another) diseases.
Additional conditions under which the test may be performed:
What Abnormal Results Mean
Enlarged nodes (swollen glands) that have a foamy appearance may indicate a lymphatic cancer. Nodes or parts of the nodes that do not fill with the contrast material may indicate a cancer spreading throughout the system. Blockage of the lymph vessels may be caused by tumor, infection, trauma, or previous lymphatic surgery.
There is a possibility of an reaction to the contrast medium. An infection is possible at the site of the injection. The dye or contrast material may cause a fever and inflammation of the lymph vessels.
There is low radiation exposure. However, most experts feel that the risk of most x-rays is smaller than other risks we take every day. Pregnant women and children are more sensitive to the risks of the x-ray.
The contrast medium can stay in the nodes for up to 2 years.
Update Date: 5/3/2006