Desprez-Curely J P
Service de Radiothérapie Carcinologique, Hôpital St. Louis, Paris.
J Mal Vasc. 1990;15(2):159-62.
It is a pity that, in view of its important prognostic value and for technical reasons, or because of problems of interpretation, lymphography should no longer be part of a routine work-up for diagnosing melanoma. Indeed, bipedal lymphography can accurately reveal the extent of node invasion in case of palpable adenopathy. It provides for the monitoring of the retroperitoneal lymph nodes after inguinal curettage has been accomplished. This method may reveal metastases at the subclinical stage. Axillary lymphography is especially valuable in case of palpable adenopathy. It has prognostic value in case of positive isotopic-clinical node involvement. Above all, however, it enables discarding the diagnosis of any secondary invasion, and preventing otherwise systematic axillary node curettage in 41% of cases. Lastly, if findings are normal, it affords a means for long-term follow-up.
遗憾的是，鉴于淋巴造影术具有重要的预后价值，但由于技术原因，或因解释问题，它不应再作为诊断黑色素瘤常规检查的一部分。实际上，双侧淋巴造影术在可触及淋巴结肿大的情况下能够准确显示淋巴结侵犯的程度。在腹股沟刮除术后，它可用于监测腹膜后淋巴结。该方法可能在亚临床阶段发现转移灶。腋窝淋巴造影术在可触及淋巴结肿大的情况下尤其有价值。在同位素 - 临床检查发现淋巴结受累呈阳性的情况下，它具有预后价值。然而，最重要的是，它能够排除任何继发性侵犯的诊断，并在41%的病例中避免进行系统性腋窝淋巴结刮除术。最后，如果检查结果正常，它为长期随访提供了一种手段。
