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Lívia Maria Pereira de Godoy, Paula Pereira de Godoy Capeletto, Maria de Fátima Guerreiro Godoy, Jose Maria Pereira de Godoy
Objective: The aim of the present study is to report on the reduction of edema of lymphedematous arms just by treating the lower limbs. Methods: A 16-year-old girl reported that she has started having right lower limb edema at the age of three. At age 13, she performed a lymphoscintigraphy that confirmed the diagnosis of primary lymphedema of the four limbs. Recently she sought treatment at the Clínica Godoy in São Jose do Rio Preto where she was submitted to intensive treatment for eight hours per day for five days using manual (Godoy & Godoy technique) and mechanical lymphatic therapy (RA Godoy® ) of the lower limbs, cervical lymphatic therapy (cervical stimulation), and the continuous use of a grosgrain stocking...
2018: Case Reports in Pediatrics
Elizabeth O Kenworthy, Jonas A Nelson, Richa Verma, JeanJacques Mbabuike, Babak J Mehrara, Joseph H Dayan
BACKGROUND AND OBJECTIVES: Orthotopic vascularized lymph node transplant has been successfully used to treat lymphedema. A second, heterotopic lymph node transplant in the distal extremity may provide further improvement. The vascularized omentum lymphatic transplant (VOLT) provides adequate tissue for two simultaneous flap transfers to one limb. The purpose of this study was to review our experience with this technique. METHODS: We conducted a retrospective study of patients who underwent VOLT, with a subgroup analysis of patients who underwent double VOLT...
March 8, 2018: Journal of Surgical Oncology
V Balaya, H Bonsang-Kitzis, C Ngo, M Delomenie, M Gosset, M Mimouni, C Nos, P M David, A S Bats, F Lecuru
Pregnancy-associated breast cancer is rare, but this clinical situation arises in 1/10,000 to 1/3,000 pregnancies. In patients presenting an early-stage breast tumor devoid of clinically pathological lymph node, sentinel lymph node (SLN) biopsy has not yet been validated as a routine procedure for pregnant women due to the lack of data in the literature. The blue dye injection is not recommended because of 2% theoretical risk of anaphylactic shock. Several studies have shown that Tc99m injection at conventional dose between 12...
March 3, 2018: Journal of Gynecology Obstetrics and Human Reproduction
Derrek A Heuveling, K Hakki Karagozoglu, Arthur Van Lingen, Otto S Hoekstra, Guus A M S Van Dongen, Remco De Bree
BACKGROUND: PET/CT lymphoscintigraphy using 89 Zr-nanocolloidal albumin has the potential to improve the preoperative identification of sentinel lymph nodes (SLNs), especially if located in the near proximity of the primary tumour. This study aims to demonstrate the feasibility of PET/CT lymphoscintigraphy followed by intraoperative detection of 89 Zr-nanocolloidal albumin containing SLNs with the use of a handheld high-energy gamma probe. METHODS: PET/CT lymphoscintigraphy was performed after peritumoural injection of 89 Zr-nanocolloidal albumin in five patients with oral cavity carcinoma planned for surgical resection...
February 14, 2018: EJNMMI Research
Michael J Sladden, Omgo E Nieweg, Julie Howle, Brendon J Coventry, John F Thompson
Definitive management of primary cutaneous melanoma consists of surgical excision of the melanoma with the aim of curing the patient. The melanoma is widely excised together with a safety margin of surrounding skin and subcutaneous tissue, after the diagnosis and Breslow thickness have been established by histological assessment of the initial excision biopsy specimen. Sentinel lymph node biopsy should be discussed for melanomas ≥ 1 mm thickness (≥ 0.8 mm if other high risk features) in which case lymphoscintigraphy must be performed before wider excision of the primary melanoma site...
February 19, 2018: Medical Journal of Australia
Sophie Turpin, Raymond Lambert
Objective: In the pediatric setting, lymphoscintigraphy is mostly used for the evaluation of lymphedema. Only a few cases of chylous anomalies and lymphatic malformations imaged with lymphoscintigraphy, have been reported in the literature. The aim of this study was to review the use of lymphoscintigraphy in those pathologies. Methods: All lymphoscintigraphies obtained between 2001 and 2017 in our hospital for chylous anomalies were retrospectively reviewed. Results were correlated to clinical and radiological findings...
February 2, 2018: Journal of Nuclear Medicine Technology
Xue Yu, Na Jia, Sanxia Ye, Min Zhou, Deping Liu
Primary chylopericardium (CP) is a rare clinical condition in which chylous fluid containing high concentrations of triglyceride accumulates in the pericardial cavity. The present study reports a case of CP that was successfully treated by reconstruction surgery of thoracic duct. To improve the ability to diagnosis and treat this rare disease, the current study also systematically extracted 104 reported cases of primary or idiopathic CP from the past 60 years (January 1950 to December of 2015), and reviewed the clinical manifestation, etiology, diagnosis and treatment of these cases...
January 2018: Experimental and Therapeutic Medicine
Manish Chand, Deborah S Keller, Laurence Devoto, Mark McGurk
To describe an innovative sentinel lymph node (SLN) guidance approach using a radionuclide tracer, 3D augmented reality-guided imaging, and near infrared (NIR) fluorescence over-lay imaging with hand-held probes to optimize accuracy, efficiency, and precise navigation for sentinel node (SN) localization in head and neck cancer. In a cT1N0M0 squamous cell carcinoma of the tongue, pre-operative radionuclide lymphoscintigraphy was performed with a sentinel node-specific radiolabeled tracer. Intraoperatively, a 3D hand-held augmented reality (AR) scanning SPECT probe assessed concordance of the SN with pre-operative SPECT-CT images...
January 22, 2018: Journal of Fluorescence
Paul Kim, Ju Kang Lee, Oh Kyung Lim, Heung Kyu Park, Ki Deok Park
Objective: To predict the probability of lymphedema development in breast cancer patients in the early post-operation stage, we investigated the ability of quantitative lymphoscintigraphic assessment. Methods: This retrospective study included 201 patients without lymphedema after unilateral breast cancer surgery. Lymphoscintigraphy was performed between 4 and 8 weeks after surgery to evaluate the lymphatic system in the early postoperative stage. Quantitative lymphoscintigraphy was performed using four methods: ratio of radiopharmaceutical clearance rate of the affected to normal hand; ratio of radioactivity of the affected to normal hand; ratio of radiopharmaceutical uptake rate of the affected to normal axilla (RUA); and ratio of radioactivity of the affected to normal axilla (RRA)...
December 2017: Annals of Rehabilitation Medicine
Svend Hvidsten, Navid M Toyserkani, Jens A Sørensen, Poul F Høilund-Carlsen, Jane A Simonsen
BACKGROUND: Lymphoscintigraphy is commonly used to assess breast cancer-related lymphedema. However, a reliable quantitative method that clearly distinguishes normal lymphatic function from lymphedema is desired. We propose a quantitative method based upon the physiological mean transit time (MTT) measure of lymph fluid passing through the arm. METHODS AND RESULTS: Eleven patients, aged 34-68 years, with unilateral arm lymphedema following breast cancer treatment underwent simultaneous bilateral lymphoscintigraphy using intradermal injection of 99mTc-labeled human serum albumin (HSA)...
January 18, 2018: Lymphatic Research and Biology
Makoto Mihara, Hisako Hara, Yoshihisa Kawakami, Han Peng Zhou, Shuichi Tange, Kazuki Kikuchi, Takuya Iida
BACKGROUND: Histological changes in the collecting lymphatics in patients with lymphedema are classified as Normal type, Ectasis type, Contraction type, and Sclerosis type (NECST) classification. In this study, we investigated the condition of the lymphatic vessels in different sites of the legs. PATIENTS AND METHODS: We prospectively investigated the lymphatic vessels of patients with lymphedema who underwent lymphaticovenous anastomosis (LVA) from August 8, 2014 to August 4, 2015 based on the NECST classification...
January 17, 2018: Lymphatic Research and Biology
Becky B Trinh, Brandon C Chapman, Ana Gleisner, Jennifer J Kwak, Rustain Morgan, Martin D McCarter, Csaba Gajdos, Nicole Kounalakis
BACKGROUND: Planar lymphoscintigraphy (PL) has a lower detection rate of sentinel lymph nodes (SLNs) in head and neck melanoma compared with other sites. We assessed situations when single-photon emission computed tomography/computed tomography (SPECT/CT) identified nodes not seen by PL. We also evaluated the impact of SPECT/CT on surgical approach and oncologic outcomes. METHODS: Patients who underwent SLN biopsy (SLNB) for head and neck melanoma with PL and SPECT/CT between November 2011 and December 2016 were included...
January 12, 2018: Annals of Surgical Oncology
Yong Min Kim, Chul Moon, Dong Erk Goo, Soo Bin Park, Ji Woong Park
RATIONALE: Among the causes of swelling in the extremities of renal transplantation patients, secondary lymphedema caused by complete idiopathic obstruction of large veins is rare and may be difficult to diagnose and treat. PATIENT CONCERNS: A 64-year-old man presented with severe edema and pain that occurred suddenly in the right arm. DIAGNOSES: The patient was diagnosed as stage-2 secondary lymphedema caused by idiopathic occlusion of the subclavian and innominate veins...
December 2017: Medicine (Baltimore)
Jae Seok Bae, Roh-Eul Yoo, Seung Hong Choi, Seong Oh Park, Hak Chang, Minseok Suh, Gi Jeong Cheon
PURPOSE: To validate usefulness of magnetic resonance (MR) lymphangiography for evaluation of peripheral lymphedema in upper extremities by comparison with lymphoscintigraphy. MATERIALS AND METHODS: This prospective study had institutional review board approval and written informed consent was obtained from all patients. Initially, protocol of MR lymphangiography for upper extremity was established in seven healthy volunteers with 3.0T fat-saturated three-dimensional gradient-echo MR after gadobutrol injection...
January 3, 2018: Magnetic Resonance Imaging
Mariana Maia Freire de Oliveira, Maria Salete Costa Gurgel, Bárbara Juarez Amorim, Celso Dario Ramos, Sophie Derchain, Natachie Furlan-Santos, César Cabello Dos Santos, Luís Otávio Sarian
PURPOSE: evaluate whether manual lymphatic drainage (MLD) or active exercise (AE) is associated with shoulder range of motion (ROM), wound complication and changes in the lymphatic parameters after breast cancer (BC) surgery and whether these parameters have an association with lymphedema formation in the long run. METHODS: Clinical trial with 106 women undergoing radical BC surgery, in the Women's Integrated Healthcare Center-University of Campinas. Women were matched for staging, age and body mass index and were allocated to performed AE or MLD, 2 weekly sessions during one month after surgery...
2018: PloS One
Masao Fujiwara, Takahiro Suzuki, Akira Kasuya, Takatoshi Shimauchi, Hidekazu Fukamizu, Yoshiki Tokura
BACKGROUND: The status of sentinel lymph node (SLN) is one of the most predictive prognostic factors in patients with clinically localized malignant melanomas (MMs). However, since the positive SLN metastatic rate is as low as 20%, it is desirable to minimize SLN biopsy performance with imaging. By dynamic lymphoscintigraphy, we have proposed the lymphatic transit rate (LTR), the value that the distance between the primary lesion and SLN is divided by scintigraphic saturation time. LTR represents the scintigraphic saturation velocity and can be used for evaluation of metastasis of skin cancers...
December 24, 2017: Journal of Dermatological Science
Ji-Young Kim, Hyunjong Lee, Tae Sung Kim, Han-Sung Kang, Seok-Ki Kim
Contralateral metastatic axillary lymph nodes in a patient with breast cancer is a rare condition. Here, we present a 55-year-old woman with a second primary breast cancer. The patient underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) for staging work-up. Additionally, preoperative lymphoscintigraphy was performed to detect sentinel lymph nodes. FDG PET/CT demonstrated increased FDG uptake in the left nipple and right axillary lymph nodes. Lymphoscintigraphy identified the right axillary lymph nodes which was consistent with the FDG PET/CT findings...
December 2017: Nuclear Medicine and Molecular Imaging
Teele Kuusk, Roderick De Bruijn, Oscar R Brouwer, Jeroen De Jong, Maarten Donswijk, Nikolaos Grivas, Kees Hendricksen, Simon Horenblas, Warner Prevoo, Renato A Valdés Olmos, Henk G Van Der Poel, Bas Wg Van Rhijn, Esther M Wit, Axel Bex
PURPOSE: Lymphatic drainage from renal tumors is unpredictable and in vivo drainage studies of primary lymphatic landing sites may reveal the variability and dynamics of lymphatic connections. The purpose of this study was to investigate the lymphatic drainage pattern from renal tumors in vivo with SPECT/CT imaging after intra-tumoral radiotracer injection. MATERIALS AND METHODS: We conducted a phase II prospective single-arm study to investigate the distribution of SNs from renal tumors on SPECT/CT imaging...
December 6, 2017: Journal of Urology
Georgia Keramida, Emma Wroe, Nicola Winterman, Mark Aplin, A Michael Peters
Background Following convection from blood capillaries, plasma proteins are transported to loco-regional lymph nodes in two stages: first, uptake into peripheral lymphatics, and second, transport to nodes. Purpose To introduce a new parameter of lymphatic function that quantifies stage 2 - lymphatic drainage efficiency (LDE). Material and Methods Percentage injected activity (IIQ) in ilio-inguinal nodes 150 min following subcutaneous foot web-space injection of Tc-99 m-nanocolloid was measured in 102 patients undergoing lymphoscintigraphy using a method in which a standard is placed by image guidance over the nodes...
January 1, 2017: Acta Radiologica
Gabriela E Jones, Sahar Mansour
Lymphoedema is the build-up of lymphatic fluid leading to swelling in the tissues. Most commonly it affects the peripheries. Diagnosis is based on clinical assessment and imaging with lymphoscintigraphy. Treatment is supportive with compression garments, massage, good skin hygiene and prompt use of antibiotics to avoid the complication of cellulitis. Most commonly, lymphoedema occurs as a result of damage to the lymphatic system following surgery, trauma, radiation or infection. However, it can be primary, often associated with a genetic defect that causes disruption to the development of the lymphatic system...
December 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
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