Lymphography with Radioactive Contrast Medium in Lymphosarcoma and Reticulosarcoma

Since 1961 we have been using a method of lymphography based on the intralymphatic injection of an oily contrast medium (Lipiodol Fluide) rendered radioactive by replacement of the inactive iodine by its isotope 131I (Chiappa, Galli, Barbaini and Ravasi, 1962; Ratti, 1962; Buraggi, D'Amico and Fava, 1963). The method has recently been taken up by other workers (Seitzman, Wright, Halaby and Freeman, 1963). The method combines lymphadenographic investigation with elective radiotherapy of tumours located in the lymph nodes. The most promising results have been achieved in the treatment of systemic lymph node diseases, such as Hodgkin's disease, lymphosarcoma and reticulosarcoma (Chiappa et al., 1962; Chiappa, Galli, Guarino, Barbaini and Ravasi, 1963a; Chiappa and Galli, 1963). In a preliminary review of the case material treated at the Institute of Radiology (Chiappa, Galli and Severini, 1964), we reported the diagnostic and therapeutic results obtained in Hodgkin's disease. The purpose of the present paper is to summarize our experience of lymphadenography with radioactive Lipiodol in lymphosarcoma and reticulosarcoma. We have treated 14 cases of lymphosarcoma, 18 cases of reticulosarcoma and three cases in which the histological diagnosis was lymphoreticulosarcoma. Five cases of lymphatic leukaemia, leukaemic and non‐leukaemic, have been included with the lymphosarcoma patients, because of the resemblance between the two in morbid anatomy, clinical course and lymphadenographic findings. The series thus totals 40 patients. Although the various diseases are histologically and clinically different, they have certain lymphographic features in common: (a) the topographic distribution of the lymph node tumours within the area studied and, even more important, (b) the similarity of their response to irradiation with Lipiodol F131I.