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*

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

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

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*

PURPOSE: Lymphoscintigraphy and sentinel node biopsy has become a standard method for detection of axillary lymph node metastasis in breast cancer patients, but the standard radiopharmaceutical was not prepared. About detection of axillary lymph node metastasis by lymphoscintigraphy and sentinel node biopsy in breast cancer patient, we compared the results of Tc-99m Tin-colloid and Tc-99m Phytate by subareolar injection. MATERIALS AND METHODS: This study included 382 breast cancer patients who were performed operation during 2001-2008. Three hundred forty nine patients was injected 0.8 ml of Tc-99m Tin-colloid (37-185 MBq) by subareolar injection. Thirty three patients was injected 0.8 ml of Tc-99m Phytate (37-185 MBq). Lymphoscintigraphy was performed in supine position and sentinel node localization was performed by hand-held gamma probe in operation. RESULT: Among 349 patients by Tc-99m Tin-colloid, 312 cases (89.4%) localized the sentinel node by lymphoscintigraphy, 304 cases (87.1%) localized by gamma probe. Among 33 patients by Tc-99m Phytate, 32 cases (97.0%) localized by lymphoscintigraphy, 33 cases (100%) localized by gamma probe. Detection rate by lymphoscintigraphy and gamma probe was superior for Tc-99m Phytate compared to that with Tc-99m Tin-colloid, with a statistically significant difference. (p<0.05, p<0.05) CONCLUSION: Tc-99m Phytate is a better choice for localization of sentinel node than Tc-99m Tin-colloid in breast cancer patients.
Biopsy ; Breast ; Breast Neoplasms ; Humans ; Lymph Nodes ; Lymphoscintigraphy ; Neoplasm Metastasis ; Nitriles ; Phytic Acid ; Pyrethrins ; Supine Position

BACKGROUND: In malignant melanoma, the regional nodal status is acknowledged as the most powerful indicator of prognosis. Sentinel lymph node status was formally adopted in 2002 AJCC melanoma staging system. However, there has been no clinical study on sentinel lymph node evaluation, especially using lymphoscintigraphy and gamma probe in melanoma patients in Korea. OBJECTIVE: Our purpose was to assess the usefulness of lymphoscintigraphy and intraoperative gamma probe for the detection of sentinel lymph node in melanoma patients. METHODS: In eight malignant melanoma patients (7 stage I/II, 1 stage III), a lymphoscintigraphy with 99mTc-radiocolloids were injected peritumoral area and the identified first lymph node was considered to be a sentinel node. Once the sentinel lymph node was identified using a hand-held gamma probe for intraoperative mapping, it was excised. And the sentinel node was examined by routine hematoxylin-eosin and immunohistochemical stain (HMB45, S-100). RESULTS: Sentinel nodes were identified in 8 patients all using lymphoscintigraphy and intraoperative gamma probe. Nine sentinel nodes were found in 8 patients, and sentinel lymph node biopsies showed micrometases in 5(55.5%). The location of sentinel nodes was that 3(33.3%) were located in axilla, and 6(66.6%) in groin. The case that had melanoma on back revealed dual lymphatic pathway with 2 sentinel nodes on axilla and inguinal area. CONCLUSIONS: We conclude that preoperative lymphoscintigraphy and intraoperative gamma-probe guided sentinel lymph node biopsy is useful for acute staging and prediction of prognosis for melanoma patients.
Axilla ; Biopsy ; Groin ; Humans ; Korea ; Lymph Nodes ; Lymphoscintigraphy* ; Melanoma* ; Prognosis ; Sentinel Lymph Node Biopsy*

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

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*