Sometimes we have to do special tests to see exactly what's going on inside our bodies, right? Well, this is an important test called Lymphangiography, which is done to find out if there's anything wrong with our lymphatic system (we'll talk about this in a bit). Don't worry, we'll talk about this simply, in a way that you can understand.
What is Lymphangiography? What does it involve?
Simply put, (Lymphangiography) is an imaging test that takes pictures of your lymphatic system . Think about it, we have a network of lymph vessels in our body, just like blood vessels? Those lymph vessels, lymph nodes (I'll talk about these too) are what this clearly looks at. In this, a special dye is injected into your body. This dye is also called ( Lipoidal). Then, an (X-ray) machine or (MRI) machine is used to take pictures of the lymphatic system. If an (MRI) is used, the method is called (Magnetic Resonance Lymphangiography) or (MR Lymphangiography).
Now you may be wondering what the lymphatic system is . It is an important part of our immune system (the system that protects us from disease) and the circulatory system (the system that carries blood throughout the body). In it, there is a network of vessels that carry a clear fluid called lymph throughout the body. This lymph acts like a filter, collecting excess fluid and waste that accumulates in the body. Also, this system includes glands called lymph nodes . These are the ones that produce cells that fight infection. They are like little security checkpoints in our body.
These parts of the lymphatic system are not clearly visible on normal imaging tests. That's why a special dye is used in lymphangiography. This dye allows the lymph vessels and lymph nodes to be clearly seen in pictures, called lymphangiograms. This test is also called lymphography.
Why is this (Lymphography) test done?
Doctors use this test (Lymphangiography) for a few reasons. Let's take a look at what they are:
- Identify if you have any disease in your lymphatic system.
- Find out if the disease has spread to other parts of the body.
- When treating, determine where the most effective treatment can be delivered (treatment guidance). It's like giving medicine to the target.
- Before surgery or other medical intervention, create a map of your lymphatic system. This will be a great help to the surgeon.
- See if the treatments are helpful and if they are effective .
This test helps to diagnose and manage conditions such as:
- A leak of fluid from the lymphatic system ((Lymphatic leak)) or an injury.
- Lymphedema is a condition in which the lymphatic system swells, causing swelling in areas such as the limbs.
- A type of cancer called Hodgkin lymphoma.
- A type of cancer called Non-Hodgkin lymphoma.
Who performs this (Lymphangiography) test?
Lymphangiography is usually performed by an interventional radiologist . He/she is a doctor who specializes in diagnosing and treating diseases using medical imaging and minimally invasive procedures. That is, someone who inserts instruments through small holes, rather than making large incisions.
How should I prepare before the test?
Your doctor will give you clear instructions on how to prepare for this test. These instructions may include:
- Avoid eating or drinking for a few hours before the test, usually about 6 to 8 hours.
- Before going to the test , go to the bathroom and empty your bladder .
- Tell your doctor if you are pregnant or have any bleeding problems (such as a blood clotting disorder).
- You may be given a sedative to help you relax , which will help reduce any fear you may have about the test.
- If you have had an allergic reaction to iodine or other medical tests in the past, you should definitely tell your doctor.
- If you have a history of heart disease , especially a condition called Patent Foramen Ovale (PFO) (which is a small hole in the heart), tell your doctor about it as well.
Sometimes, a lymph node biopsy, which involves removing a small piece of lymph node for examination, may be done during this test. In this case, you may be given anesthesia to prevent you from feeling any pain.
What happens during a lymphangiography test?
Okay, now let's see what happens during the test.
First, the doctor will ask you to sit or lie down on an examination chair or table. Then, a small area of your skin will be cleaned and a small amount of blue dye will be injected. You may feel a slight stinging sensation when this injection is given, but it will only last a short time.
These dye injections are most commonly given in these areas:
- Close to your groin area (this is what is most often done).
- Between the fingers (this is done a little less often).
- Between the toes (this is also done less often).
This blue dye causes blue lines to appear. These are the lymph channels that are clearly visible. The doctor then injects a numbing medicine into the area where the blue lines are. A small incision is made and a thin, flexible tube , like a small cannula, is inserted.
Another special dye (like Lipoidal) is slowly injected into the body through this tube over about an hour. You may feel some pressure or a feeling of fullness as the dye goes into your body.
Sometimes the doctor uses an ultrasound machine to precisely insert this tube. This means looking inside the body with sound waves. Other times, a pump called an insufflator is used to help inject this dye into the body.
Next, the doctor will take pictures of the inside of your body using a special X-ray technique called fluoroscopy or an MRI machine. Fluoroscopy is like moving X-ray pictures.
This machine projects images of your lymphatic system onto a screen. It can check whether the dye is circulating properly throughout your body, much like watching cars on a road.
After the dye is injected and has spread throughout your body, the doctor will remove the tube and put one or two stitches over the incision. Then, pictures will be taken of your legs, pelvis, abdomen, chest, and any other suspicious areas. You may also need to take a few more pictures later to see how the dye has spread.
How are you after the test?
(Lymphangiography) The incision site may be slightly sore and tender for a few days after the test. The doctor will give you painkillers for this.
The most important thing is that until the dye is completely gone, your skin color (especially your palms and soles), urine, and stools may also turn a little blue/green . This is normal, don't worry. This will go away in a few days. However, some dye may remain in your lymph nodes for up to two years. That's okay too.
If you can, get some rest the day of the test. Avoid strenuous activity. Keep the incision area clean as your doctor tells you to.
Are there any risks with this test?
Lymphangiography is generally a safe test . Like other X-ray tests, it uses radiation. But the amount of radiation is not high enough to cause you any problems. However, if any symptoms occur, they may include:
- An allergic reaction to the dye or something else (such as itching, hives, difficulty breathing)
- Bleeding from a cut.
- Infection at the incision site (redness, swelling, pus, fever)
- Inflammation of lymphatic vessels, that is, swelling.
"But again, these risks are very rare . Your doctor will tell you about all of this in advance. If you have any concerns, don't be afraid to ask."
When will I know the results of the test?
In most cases, the results of the lymphangiography test can be reported to the doctor on the same day . Sometimes, if necessary, treatment can be given while the lymphangiography test is being performed.
However, in some cases, a team of specialists, for example an interventional radiologist and an oncologist, come together to discuss these results and make decisions. In that case, it can take a day or two to get the results.
Your doctor will talk to you about these results and explain what they mean. For example, if the dye can't pass through a spot, it could mean there's something blocking it. It could be a tumor, an injury, or an infection. Also, if the lymph nodes are enlarged, have a different shape, or look like foam, it could be a sign of lymphatic cancer.
What symptoms should I see a doctor if I develop after the test?
After the test, if you have any of these signs of an allergy or infection, call your doctor or go to a hospital immediately:
- Fever or chills .
- Severe pain at the incision site (especially pain that increases and does not subside despite taking medication).
- If the area where the cut was is red, swollen, feels hot to the touch, and if there is a pus-like fluid coming out of it .
- A skin rash , meaning redness, blistering, or swelling, appears elsewhere on the body.
- If you have difficulty breathing or chest pain.
Take care of these things.
So, what do we need to remember from all of this?
Lymphangiography is a special X-ray test that helps doctors diagnose and treat conditions such as tumors, swelling, infections, and fluid leaks in the lymphatic system.
Your doctor will explain to you in detail why you need to have this test and what the results will be. There is no reason to be afraid. This is to improve your health and provide you with the most appropriate treatment. Ask your doctor any questions or concerns you may have.
` Lymphatic system, lymphangiography, lymphatic vessels, lymph nodes, diagnosis, medical tests, dye test
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