Direct contrast lymphography of lower limb lymphatics: a lesson from the past contributing to a better understanding lower limb lymphedema after gynecological cancer treatment

Abstract

We present X-ray images of the course of lower limb lymphatics visualized by direct oil contrast lymphography. Contrast X-ray lymphography is an obsolete imaging method that provides detailed information about the course and localization of lymphatics.

This is due to the nature of the contrast, which only flows though lymphatic tissues and where it temporarily accumulates, thus enabling a large area of lymphatic drainage to be imaged. A total of 48 direct oil contrast X-ray lymphographies were evaluated, which were performed on healthy women between 1975 and 1977.

The images show that lymph from the lower limb passes primarily through all lymphatic basins that are important in the surgical staging of gynecological cancers: inguinofemoral, pelvic and para-aortic.