LYMPHOSCINTIGRAPHY IN CHYLURIA, CHYLOPERITONEUM AND CHYLOTHORAX

Lymphoscintigraphy allows functional assessment of lymphatic transport and depiction of regional lymph nodes, is fast and nontraumatic and h as no known side effects. We retrospectively analyzed lymphoscintigrap hic studies to determine their efficacy in the investigation of chylur ia, chyloperitoneum and chylothorax. Methods: Twenty-one whole-body ly mphoscintigrams using Tc-99m-antimony sulfide colloid or dextran were acquired in 18 patients with chyluria, chyloperitoneum and/or chylotho rax. The images were reviewed to assess the rate of tracer transport a nd number, size and distribution of lymph vessels and nodes as well as the presence of collateral, fistula or lymph reflux. Results: Lymphos cintigraphy was normal (5 of 11 patients) or showed lymphatic obstruct ion (6 of 11 patients) in chyluria associated with filariasis. Lymphat ic obstruction was demonstrated in chyloperitoneum and/or chylothorax associated with liver cirrhosis (2 patients), postoperative (1 patient ) or congenital (1 patient) lymphatic dysplasia, inferior vena cava ob struction (1 patient) and nephrotic syndrome(1 patient). Enhanced lymp h flow was seen in systemic lupus erythematosus (1 patient). Follow-up lymphoscintigrams showed patency of lymphovenous anastomosis (1 patie nt), improvement (1 patient) or no change (1 patient) in lymphatic dra inage after treatment. Conclusion: Lymphoscintigraphy can demonstrate abnormal lymphatic drainage in chyluria, chyloperitoneum and chylothor ax. It is useful for selecting patients for surgery and assessing the effect of treatment.