Differential diagnosis of lymphedema after indirect lymphography with Iotasul.

Indirect lymphography with Iotasul (interdigital, intradermal infusion) was performed in 32 patients with lymphedema. No side effects were observed. Opacification of the peripheral lymph vessels reveals two distinct patterns: 1. No, few, or only very small-calibre lymph vessels ("hypoplasia"): 17 patients (primary lymphedema in 14 cases, secondary in 3). 2. Many large-calibre (dilated) lymph vessels ("hyperplasia"): 15 patients (primary lymphedema in 2 cases, secondary in 13). An occasional finding in "hypoplasia" is drainage of the contrast material in the region of the adventitia of vessels, and a network of extremely fine lymph vessels apparently corresponding to the dermal plexus is sometimes observed. Because it leads to the opacification of barely perceptible lymph vessels in the extreme periphery which were previously inaccessible to radiology, indirect lymphography offers a genuine gain in information and improves the differential diagnosis. When administered correctly, Iotasul invariably enhances the peripheral lymph vessels without making any great demands of the patient or investigator.