J Korean Radiol Soc.  1983 Sep;19(3):616-625. 10.3348/jkrs.1983.19.3.616.

Value of lymphography before and after radical hysterectomy in carcinoma of the uterine cervic

• Kim CY
• Oh YH
• Yang WJ
• Bahk YW

• KMID: 2463166
• DOI: http://doi.org/10.3348/jkrs.1983.19.3.616

Abstract

Radiological demonstration of lymph vessels and lymph nodes may be achieved only by direct lymphography, whichis perfomred by injecting contrast material directly into the lymph vessels. lymph nodes, or occasionally intolymph cysts. Clinical lymphography is performed essentially according to the direct technique of Kinmonth(1952 &1954). Lymphography has become a routine procedure in patients with carcinoma of the uterine cervix. Thoroughassessment of the extent of carcinoma of the uterine cervix is necessary to the intellignet management of anypatient with uterine carcinoma. This presentation is to outline the technique of lymphangio-adenography(lymphography), lymphographic finding and diagnostic criteria of the cervical carcinoma, and evaluation of theaccuracy of lymphographic diagnosis in cervical carcinoma. A retrospective reivew of the lymphograms of 145patients with carcinoma of the uterine cercix was undertaken. All lymphograms were performed at Kang Nam St.Mary's and St. Mary's Hospitals, Catholic Medical College form 1975 to 1982. Of thse patients 87 were got radicalhysterectomy and lymphographic diagnosis was compared with tissue pathology of the nodes removed, and determinedthe diagnostic accuracy of lymphography. Lymphography can make a significant contribution in the pretreatmentassessment of patients with carcinoma of the uterine cervix. Strict adherence to rigid criteria will yieldexcellent pathologic correlation in the event of a positive radiographic diagnosis of metastatic carcinoma. Once apositive diagnosis is made, it should influence the management of the cancer patients. The results were as follow;1. The accuracy of lymphography in diagnosing lymph node metastasis of carcinoma of the uterine cervix was 85.1%,82.4% in sensitivity and 86.8% in specificity. 2. Metastic lymph nodes were moderately to markedly enlarged andirregular in shape and shown motheaten marginal filling defects in 92.7%. Theses ranged from 3mm to 20mm in thegreatest diameter. 3. Metastatic lymph nodes showed a tendency to get increased in size, inproportion to the sizeof marginal filling defect. 4. The size of filling defect of metastatic lymph nodes was not correlated to theclinical stage of carcinoma of the uterine cervix. 5. Lymph node metastasis was confirmed in 6 patients of 10patients who were got lymphography in 2 to 5 years after radical hysterectomy. 6. Many collateral lymphatics andlymphatic cysts were found out in the lymphography after radical hysterectomy in carcioma of the uterine cerix.

MeSH Terms

Cervix Uteri
Diagnosis
Female
Humans
Hysterectomy*
Lymph Nodes
Lymphography*
Neoplasm Metastasis
Pathology
Retrospective Studies
Sensitivity and Specificity