Journals at the University of Arizona
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ENDOLYMPHATIC RADIOTHERAPY IN MALIGNANT LYMPHOMAS - LONG TERM RESULTS
No full textThe lymphatic vessels of the dorsum of the foot have been used in the past seven years to inject with and without contrast material (Lipiodol, Ethiodol) different radioactive isotopes (131I, 198Au, 00Y) in the attempt to treat metastatic retroperitoneal adenopathies of lymphomatous or carcinomatous type (l, 8, 12, 13, 15, 16, 17, 19, 26, 27, 28, 31). Due to the relatively simple technique (25, 35) the intralymphatic injection of radioactive isotopes has been tried first by Chiappa in Milan in 1961 (11) and pursued by numerous investigators throughout the world. In our Institutes since September 1961 a large program has been undertaken with the administration of Lipiodol fluid 131I (endolymphatic radiotherapy) in malignant lymphomas, chronic lymphatic leukemia, carcinomas of testicle, cervix, prostate, urinary bladder, rectum and malignant melanoma (8, 11, 12, 13, 15, 16, 17, 27).Special attention has been focused on malignant lymphomas and after two and a half years of experimental clinical trials, a therapeutic program including the systematic administration of Lipiodol 131I to all cases with histologically proved malignant lymphomas was started in May 1964 (3, 4). Since very high tissue doses can be delivered with endolymphatic radiotherapy (1, IO, 19, 20), the rationale for its systematic use in all lymphoma patients regardless of the clinical stage, was to see whether the administration of Lipiodol 131I could satisfactorily meet the requirements of radical, palliative and prophylactic radiotherapy. The principal aim of this report is to analize the experience achieved with 340 malignant lymphomas treated with different doses of Lipiodol 131I and to discuss the advantages, limits and side effects of endolymphatic radiotherapy. Since a systematic treatment with high doses of Lipiodol 131I has been started in May 1964, only the three year survival rate is presently available
LYMPHOSTATIC OPHTHALMOPATHY
No full textLymphostatic encephalopathy has been described in certain patients and investigatedin animal models. Among the many changes observed clinically and experimentallythe alterations of the optic nerve and the papilla have not been adequately studied
LACK OF GENETIC CONTROL OF THE LYMPHATIC PATHWAY. STUDIES ON RATS
No full textThe lymphatic route from the testis to the cisterna chyli is studied in two inbred and one random bred strain of rats. The pathway varied similarly in all three groups with no indication of genetic control
ON RADIOACTIVE LABELLING OF THE LYMPH DRAINAGE REGIONS OF THE PELVIS
No full textThe introduction of radioisotopes in the surgical management of cervical carcinoma at our clinic in 1970 constituted a major advance in this respect. Prior to surgery the lymphatic tissue of the pelvic region is labelled by subcutaneous applications of radioisotopes. Our experience shows that the body's kinetics encourage the deposition of the radionucleide and thus visualization even of the groups of lymph nodes located in the deeper layers of the pelvic region. This method allows virtually complete lymphonodectomy with resultant improvement of cure rates
DIFFUSE LYMPHANGIOMYOMATOSIS
No full textA case of diffuse lymphangiomyomatosis with involvement of the large veins of the body is reported. The clinical, pathologoanatomic and especially the roentgenologic findings are described. Interstitial lung thickening, pleural effusions and spontaneous pneumothorax are findings which together with a stasis in the lymphatic system strongly suggest the diagnosis. The extensive involvement of the venous system supports the theory of a hamartomatous nature of the disease
Measurement of Lymph Flow of the Heart*
No full textThe intrinsic lymphatics of the heart consist of subendocardial, myocardial and subepicardialplexuses. Collecting channels lie in the atrioventricular sulcus and two maintrunks drain roughly the left and right sides of the heart (1, 2, 3). Patek (I) noted thatthese two trunks form a single trunk which lies on the pulmonary artery. Symbas (3)made in vivo studies and described separate courses to the mediastinum of the left andthe right trunks. A third trunk lies posteriorly and drains part of the posterior myocardium(4). Above the roots of the aorta and pulmonary artery the number of lymphaticspathways and interconnections vary considerably as illustrated by Allison andSabiston (4)
Anatomic Patterns by Histologic Type of Localized Hodgkin's Disease of the Upper Torso*
No full textA series of 160 consecutively enrolled patients in a clinical trial of radiotherapy for localizedHodgkin's disease of the upper torso has been analysed with respect to anatomic patterns ofdisease and histologic type. The distribution of 55 patients with stage 1 disease involving asingle nodal region was used to predict distribution patterns for the remaining 105 patients ofmore advanced stage.It was found that deviations from the expected anatomic patterns were more common thanagreements. These deviations often favored a pattern of spread to anatomically adjacentregions, but this was not true in the case of spread from one side of neck to the other. Rather,extension to the contralateral neck was seen to depend on functionally contiguous pathwaysthrough mediastinum.Nodular sclerosing and mixed cell types differed strikingly in patterns of spread, with nodularsclerosing cases rarely deviating from a pattern of contiguous regional spread. The regionsinvolved were commonly first mediastinum, then neck, either left or right. In contrast, mixedcell type disease deviated only in minor ways from spread independent of site of origin. Bila_teralaxillary involvement was predicted to occur rarely on an independent spread basis, but withmixed cell disease this special anatomic pattern was reported significantly in excess
Studies on the Lymph Node-Venous Communications I. The Passage of Radioactive Serum Albumen
No full textThe passage of radioactive iodinated serum albumen (RISA) has been followed through themedial retropharyngeal lymph node of the dog by injecting RISA into one afferent lymphaticchannel and assaying for radioactivity in samples recovered from the efferent lymphatic channel,the adjacent internal jugular vein, and distally from the femoral vein. Profiles of recovery fromthe efferent lymphatic and adjacent internal jugular vein showed a rapid, sharp rise inactivity to a peak level followed by a rapid decline in activity. These peaks coincided with theinjection time. A second recovery peak from the adjacent internal jugular vein also coincidedwith subsequent timed nodal palpation. Recovery from the femoral vein showed a steadyincrease to a plateau level which was reached after cessation of injection. The amounts of nodalretention and passage were quantitated to evaluate these parameters. A simplified hypotheticalmodel is presented and discussed. The passage of RISA to the adjacent internal jugular veinindicates a direct lymph node-venous communication
Interruption of the Lymphatic Vessels and its Consequences in Total Homotransplantation of the Small Intestine-and Ri_ght Side of the Colon in Man
No full textThe problems of total lymphatic drainage interruption have been studied in a case of totalhomotransplantation of the small bowel and right colon with a clinical survival of 26 days.Marked stasis with distension of lymphatic tracts was noticed both in the mucosa of thecolostomy and in the mesentery. At postmortem examination, no lymphatic regeneration wasobserved 26 days after grafting. Histological slides of the mesentery showed areas of oedemaassociated with pronounced lymphangiectasis. The lymphatic cavities were filled with red cellsand the lymph nodes were apoplectic. The absence of lymphatic regeneration is a point of realinterest, especially concerning both the secondary sclerosis owing to the lymphedema, that wouldcompromise the function of the graft, and the absorption of fatty acids.The absorption of these acids by the venous route either directly or indirectly throughspontaneous lympho-venous anastomosis, in fact, seems to be a sufficient by-pass. Under theseconditions, ligature of the lymphatics of the transplant is a safe procedure, thus preventingretro-peritoneal lymphorrhagia or chylous ascites. However, it would be perhaps useful tocreate such a lympho-venous anastomosis in order to diminish the stasis in the transplant untilregeneration of lymphatics occurs.The abundance of lymphatic tissue at the level of the intestine and the importantrole it plays in collecting and carrying away fat absorbed from the digestive mucosasuggested that interruption of the lymphatic vessels during intestinal transplantationmight raise a number of special problems.In the light of experimental results and our own findings following intestinalhomotransplantation in man we shall attempt to bring our knowledge up to date inregard to the following five essential points:- the immediate repercussions of raised lymphatic pressure on the graft;- the late consequences of prolonged lymphatic stasis on the graft;the consequences of lymphatic interruption on absorption of fat;the possibilities of lymphatic regeneration in man;- the possible immunological consequences of lymphatic stasis on the intestinal graft
