Lymphedema is due to a defect in lymphatic drainage which may be classified as two types; primary and secondary lymphedema. The authors experienced a case of lymphedema of lower lid and conjunctiva secondary to periorbital trauma and scar revision was done to reduce lymphedema. Lymphoscintigraphy was used to evaluate lymphatic obstruction and result was satisfactory for confirming the disease.
Cicatrix ; Conjunctiva ; Drainage ; Lymphedema* ; Lymphoscintigraphy*

No abstract available.
Humans ; Lymph Nodes* ; Lymphoscintigraphy* ; Uterine Cervical Neoplasms*

Currently, dissection of the axillary or regional lymph nodes is considered the standard staging procedure in breast cancer. However, accumulating evidence is becoming available that the sentinel node concept may provide the same or even better staging information. In the case of melanoma, it is proven that the histoiogical characteristics of the sentinel node reflect the histological characteristics of the distal part of the lymphatic basin. Morbidity can be reduced significantly by the use of sentinel node dissection as several authors have reported successful introduction of this technique into clinical practice. But in breast cancer patients, there are signigicant differences in practice relating to the technology, such as radiopharmaceuticals, injection sites, volume of injectate, combination with vital blue dye, preoperative lymphoscintigraphy, etc. Valuable reports on these topics appeared in recent journals. This review is a summary of those reports for nuclear physicians interested in sentinel node detection by lymphoscintigraphy in breast cancer patients.
Breast Neoplasms* ; Breast* ; Humans ; Lymph Nodes* ; Lymphoscintigraphy ; Melanoma ; Radiopharmaceuticals

No abstract available.
Carcinoma, Merkel Cell* ; Lymph Nodes* ; Lymphoscintigraphy* ; Neoplasm Metastasis*

OBJECTIVE: To evaluate the utility of manual lymph drainage (MLD) during lymphoscintigraphy (LS) in predicting the effect of complex physical therapy (CPT). METHOD: Forty seven patients were included in this study. MLD was done for 30 minutes after one hour LS image was obtained. 24 patients were followed up for 3~6 months. According to one hour LS image, patients were assigned to visible lymph node or lymphatic vessel group (Either group) and invisible lymph node and lymphatic vessel group (Neither group), and also according to LS changes after MLD, good and poor response group. The limb volume was checked before, and immediately after CPT, and at 1 month and 3~6 months after CPT. The treatment response was evaluated by percent volume reduction (PVR). RESULTS: There were no significant differences in volume reduction between Either group and Neither group. Otherwise, good response group showed significantly greater volume reduction after CPT than poor response group. Mean PVR in the good response group was 37.02% immediately after CPT, 41.2% at 1 month after CPT, and 47.4% at 3~6 months after CPT. Mean PVR in the poor response group was 19.22% immediately after CPT, 13.0% at 1 month after CPT, and 5.21% at 3~6 months after CPT. CONCLUSION: LS changes after MLD reflected the effects of CPT more accurately than one hour LS image.
Drainage* ; Extremities ; Humans ; Lymph Nodes ; Lymphatic Vessels ; Lymphedema ; Lymphoscintigraphy*

OBJECTIVE: To evaluate the validity of quantitative lymphoscintigraphy as a useful lymphedema assessment tool for patients with breast cancer surgery including axillary lymph node dissection (ALND). METHODS: We recruited 72 patients with lymphedema after breast cancer surgery that included ALND. Circumferences in their upper limbs were measured in five areas: 15 cm proximal to the lateral epicondyle (LE), the elbow, 10 cm distal to the LE, the wrist, and the metacarpophalangeal joint. Then, maximal circumference difference (MCD) was calculated by subtracting the unaffected side from the affected side. Quantitative asymmetry indices (QAI) were defined as the radiopharmaceutical uptake ratios of the affected side to the unaffected side. Patients were divided into 3 groups by qualitative lymphoscintigraphic patterns: normal, decreased function, and obstruction. RESULTS: The MCD was highest in the qualitative obstruction (2.76+/-2.48) pattern with significant differences from the normal (0.69+/-0.78) and decreased function (1.65+/-1.17) patterns. The QAIs of the axillary LNs showed significant differences among the normal (0.82+/-0.29), decreased function (0.42+/-0.41), and obstruction (0.18+/-0.16) patterns. As the QAI of the axillary LN increased, the MCD decreased. The QAIs of the upper limbs were significantly higher in the obstruction (3.12+/-3.07) pattern compared with the normal (1.15+/-0.10) and decreased function (0.79+/-0.30) patterns. CONCLUSION: Quantitative lymphoscintigraphic analysis is well correlated with both commonly used qualitative lymphoscintigraphic analysis and circumference differences in the upper limbs of patients with breast cancer surgery with ALND. Quantitative lymphoscintigraphy may be a good alternative assessment tool for diagnosing lymphedema after breast cancer surgery with ALND.
Breast Neoplasms* ; Breast* ; Elbow ; Humans ; Lymph Node Excision ; Lymphedema* ; Lymphoscintigraphy* ; Metacarpophalangeal Joint ; Upper Extremity ; Wrist

Early diagnosis and treatment are essential for a successful treatment of malignant tumor. The malignant melanoma is notoriously acknowledged as threatening and known to readily metastasize during the early stages. The solid tumors including malignant melanoma frequently metastasize to regional lymph nodes via lymphatic vessels. During the latest clinical amelioration, it has been clearly conspicuous that early discovery of metastatic pathological alteration in sentinel lymph nodes could prevent prophylactic regional lymph node dissection. Additionally, an application of an appropriate treatment is conceivable by accurately recognizing the stages of the illness. For malignant melanoma clinically without palpable lymph nodes, through the application of lymphoscintigraphy and vital dye staining, we report two cases of malignant melanoma, microscopically metastasized in the sentinel lymph node and review the previous literatures.
Early Diagnosis ; Lymph Node Excision ; Lymph Nodes* ; Lymphatic Vessels ; Lymphoscintigraphy ; Melanoma*

PURPOSE: This study was designed to evaluate the feasibility of sentinel node biopsy (SNB) using subareolar injection of radioactive material in breast cancer. METHODS: The prospective study was performed of 112 breast cancers (T1 or T2 stages) at Ewha Womans University Mok-Dong Hospital from February 2001 to June 2003. Patients underwent lymphoscintigraphy using 99mTc sulfur colloid. The feasibility of SNB was assessed through comparison with simultaneous axillary node dissection. RESULTS: All patients were women, and the median age was 46 years. Internal mammary sentinel lymph node was identified in 2 cases (1.8%). The first node was appeared on lymphoscintigraphy around at 10.7 minutes after subareolar injection. Sentinel nodes could be identified in 111 (99.1%) among 112 patients with a gamma probe. The mean number of harvested sentinel nodes were 3.3 and metastasis was noted 80 of 368 nodes (21.7%). False negative rate was 4.1%. CONCLUSION: SNB using subareolar injection of radioactive material could be a alternative method to replace axillary node dissection in T1 or T2 breast cancers, especially in case of clinical node negative patients.
Biopsy* ; Breast Neoplasms* ; Breast* ; Colloids ; Female ; Humans ; Lymph Nodes ; Lymphoscintigraphy ; Neoplasm Metastasis ; Prospective Studies ; Sulfur

BACKGROUND: Sentinel lymph node dissection is a new therapeutic strategy of malignant melanoma. There was no clinical study about sentinel lymph node dissection in Korea. OBJECTIVE: Our purpose was to analyze the results of the treatment of malignant melanoma using sentinel lymph node dissection and to compare sentinel lymph node dissection with elective lymph node dissection. METHODS: History of 9 cases with malignant melanoma(1 case treated with elective lymph node dissection and 8 cases treated with sentinel lymph node dissection) at our institution over 2 years were reviewed. We evaluated the clinical & histopathologic data, status of sentinel lymph node and results of treatment. RESULTS: Sentinel lymph nodes were located within the regional lymph node basins in all 8 cases of extremity melanoma, except 1 case(trunk melanoma). Of 8 cases treated with sentinel lymph node dissection, the number of sentinel lymph node was 11, and positive lymph nodes was 3. Patients with positive sentinel lymph node were treated with therapeutic regional lymphadenectomy, chemotherapy and adjuvant therapy. No further treatment or only interferon administration was done in patients with negative sentinel lymph node. CONCLUSION: We confirmed the usefulness of lymphoscintigraphy and sentinel lymph node dissection using vital dye staining in the diagnosis and treatment of lymph node metastasis of melanoma.
Diagnosis ; Drug Therapy ; Extremities ; Humans ; Interferons ; Korea ; Lymph Node Excision* ; Lymph Nodes* ; Lymphoscintigraphy ; Melanoma* ; Neoplasm Metastasis

OBJECTIVE: To investigate the clinical manifestations and causes of upper limb edema in 8 patients with rheumatoid arthritis. METHODS: Eight patients with upper limb edema in association with rheumatoid arthritis were investigated for their clinical manifestations and assessment of lymphatic function with lymphoscintigrphy. In lymphoscintigraphy, 99mTc-Human serum albumin((0.3ml, 1.0mci) was injected subcutaneously into the second web space of each hand. Images were obtained over injetion site and both axillary regions at Ohr and 2hr post-injection. The visualization of axillary lymph node and the percentage uptake of isotope in the axillary regions were evaluated. RESULTS: All patients except one have unilateral upper limb edema and showed no relation between lymphedema and either activity or duration of arthritis. Six of eight cases were found to have impaired lymph drainage and two cases showed normal lymphatic function. CONCLUSION: This study describes lymphedema in patients with rheumatoid arthritis due to impaired lymphatic function and a relatively rapid production of interstitial fluid.
Arthritis ; Arthritis, Rheumatoid* ; Drainage ; Edema ; Extracellular Fluid ; Hand ; Humans ; Lymph Nodes ; Lymphedema* ; Lymphoscintigraphy ; Upper Extremity