LYMPHATIC SYSTEM LECTUREon lymph no.pptx

Lymphatic System

1. LYMPHATIC SYSTEM DR. WATITI NALIAKA. RADIOLOGIST/LECTURER JKUAT SOMED

2. I NTRODUCTION Lymphatic system is responsible for maintaining proper tissue fluid balance, the immune system and absorbing lipids from the gut. It consists of the lymphatic vessels/channels and lymph-nodes through which immune cells maintain immune response. Disruption of the lymphatic function results in lymphedema and local immune response-lymphadenopathy

3. IMAGING Lymphoscintigraphy -Nuclear medicine technique to visualize regional lymphatic drainage. -Radiopharmaceutical/radiotracer-( Technicium 99 Sulphur colloid) is injected intradermally and images are acquired with a gamma camera. -Indications-Leg swelling/ Lymphoedema , mapping of sentinel nodes. Ultrasound- Lymphadenopathy, splenomegaly MR Lymphography - Visualizes and maps the lymphatic vessels. PET CT - Nuclear medicine imaging modality that has been combined with CT. It provides metabolic and functional information. Screening of nodes in metastatic disease- staging or follow up .

4. 1.Lymphnodes/lymphadenopathy Definition: Enlargement of lymph nodes . Commonly depends on location. Insignificant if <2cm. In the axilla and inguinal region insignificant if <3cm. In the supraclavicular fossa, >1cm is significant. Causes- Infective -Reactive-Follicular hyperplasia, granulomatous disease -Neoplastic-Lymphoma, metastases -Drug induced

5. I maging Ultrasound - Initial modality for evaluation of superficial nodes-neck, inguinal, axilla. Evaluates-size, number, shape, contour, internal architecture and vascularity. CT/MRI - secondary. Can detect primary cause of adenopathy. Size, number , shape , contour, attenuation and enhancement. Also used as follow up modality to assess treatment response.

6. 2. Lymphedema Pathologic accumulation of fluid in the soft tissues due to impaired lymphatic drainage. Can be primary or secondary Primary is commonly hereditary-idiopathic. Secondary-obstruction or disruption of lymphatics system at lymph node or lymphatic channel level i ). Lymph-node level-Iatrogenic-Radiation, or surgery-nodal dissection. Tumors. ii). Lymphatic channels-iatrogenic- ilio -femoral bypass Trauma, radiation, tumor, elephantiasis.

7. Imaging. Main diagnostic modality of choice is lymphoscintigraphy . Evaluates major lymphatic channels, nodes and function. MR Lymphography - Useful in preoperative planning.

8. LYMPHOSCINTIGRAPHY

9. MR lymphogram

10. END