The lymphatics of the prostate gland and their role in the spread of prostatic carcinoma.

The results of research are reported which provide conclusive evidence of the presence of functioning intraprostatic lymphatics. The hypothesis that the prostate is an 'immunologically privileged site' devoid of demonstrable intraprostatic lymphatics is no longer valid. Intraglandular metastases via the intraprostatic lymphatics might be responsible for the multifocal presentation in prostatic carcinoma. Lymphatic spread is a primary event in a significant number of cases. The conventional separation of modes of spread as haematogenous and lymphatic seems artificial and physiologically unsound, as tumour cells tend to recycle from one system to another. The application of clinical prostatolymphography as a diagnostic tool in N-staging and as a potential therapeutic adjunct, using a suitable radioisotope, in the management of prostatic carcinoma has to be assessed.