The goal of pedal lymphography is to visualize lymphatic vessels and associated lymph nodes originating from the inferior limbs, the pelvis, the retro-peritoneal and thoracic area toward the lymph thoracic duct.
Its main indications are for lymphoma (Hodgkin's disease and non Hodgkin's lymphoma) and the study of pelvic lymph nodes (particularly from cervix uteri). Tomodensitometry has largely reduced the real indications of pedal lymphography.
The technique is performed within two days and uses an oily iodinated contrast medium.
On the first day, a vital blue dye is injected on the arches of both feet (the patient has blue skin and urine for 24 hours).
The dye is drained toward the foot lymph vessels which can be seen and catheterised. The oily iodin contrast medium is injected in these vessels with a pump for 30 to 60 minutes. When the product is seen in the thorac duct, a first sery of views is taken illustrating the lymph vessels.
On the day after, the contrast medium is concentrated inside the lymph nodes.
In case of pathological involvement of the nodes, the typical aspect shows:
an absent transit along one lymphatic vessel system (by compression) and the absence of nodes on the view taken the day after,
deviations of lymphatic vessels as compared with controlateral lymphatic vessels,
enlarged and ghostly pathological nodes.
| Diagram of pedal lymphography |
Diagram of pedal lymphography |
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| On the left side (of patient), a normal aspect with meny lymph vessels. On the right side of the patient, disparition of inguinal and external iliac lymph vessels. |
On the left side (of the patient), normal image with small regular nodes. On the right side, ghostly appearance of enlarged lymph nodes. |