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 are used in detection of axillary lymph node metastasis in breast cancer patients, but standardized technique is not established. We compared the results of the injection the morning of surgery (1 day protocol) with the subareolar injection the day before surgery (2 day protocol) with the subareolar injection in patients with breast cancer having lymphoscintigraphy and sentinel node biopsy. MATERIALS AND METHODS: This study included 349 patients who underwent the breast cancer operation during 2001-2004. One hundred seventy one patients (1 day protocol, 1 hour) was injected 0.8 ml of Tc-99m Tin-Colloid (37 MBq) by subareolar injection on the morning of surgery. One hundred seventy eight patients (2 day protocol, 16 hour) was injected 0.8 ml of Tc-99m Tin-Colloid (185 MBq) on the afternoon before surgery. Lymphoscintigraphy was performed in sitting position and sentinel node localization was performed by hand-held gamma probe during operation. Result: In the 1 day protocol, 153 cases (89.5%) of the sentinel node were localized by lymphoscintigraphy and 150 cases (87.7%) were localized by gamma probe. In the 2 day protocol, 159 cases (89.3%) were localized by lymphoscintigraphy and 154 cases (86.5%) were localized by gamma probe. There was no significant difference in localization of sentinel node between the 1 day and the 2 day protocol by lymphoscintigraphy and gamma probe (p>0.05, p>0.05). CONCLUSION: There was no difference the result of localization of sentinel node with subareolar injection between the 1 day and the 2 day protocol in breast cancer patients. Because the 2 day protocol allows the enough time of performing lymphoscintigraphy, it is more useful in localization of sentinel node in breast cancer patients.
Biopsy ; Breast ; Breast Neoplasms ; Humans ; Lymph Nodes ; Lymphoscintigraphy ; Neoplasm Metastasis ; Nitriles ; Pyrethrins ; Retrospective Studies

PURPOSE: To evaluate the usefulness of preoperative or postoperative lymphoscintigraphy for the identification of lymphatic drainage and sentinel lymph node in patients with eyeball and ocular adnexal malignant tumors. METHODS: Lymphoscintigraphy was performed preoperatively or postoperatively in 5 patients with biopsy proven primary eyeball or ocular adnexal malignant tumors. Patients underwent lymphoscintigraphy with 500 micro Ci of technetium-99m antimony trisulfide colloid in a volume of 0.1 ml. We injected intradermally either the outer 1/3 of the upper or lower lid, or the inner 1/3 of the upper or lower lid. Images were taken by Gamma camera and we checked lymphatic drainage and sentinel lymph nodes. RESULTS: Two patients with conjunctival malignant melanoma showed normal lymphatic drainage, but the other two patients had lymphatic drainage to the parotid and submandibular chain, and sentinel lymph nodes were noted as the parotid lymph node and the submandibular lymph node. The patients with sebaceous gland carcinoma injected in the outer 1/3 of the upper lid had submandibular lymphatic chain and the sentinel lymph node proved to be the submandibular lymph node. CONCLUSIONS: Lymphoscintigraphy demonstrated the lymphatic drainage system and successfully identified the sentinel lymph nodes. This should prove to be very helpful to evaluate metastasis of the eyeball and ocular adnexal malignant tumors by selective lymph node biopsy and to decide the degree of surgery.
Antimony ; Biopsy ; Colloids ; Drainage ; Gamma Cameras ; Humans ; Lymph Nodes ; Lymphoscintigraphy* ; Melanoma ; Neoplasm Metastasis ; Sebaceous Glands

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: 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