Lymphangiography is another means of showing up lymph nodes. For this a liquid form of contrast is injected into the tiny lymph channels and gradually works its way up through them. For example, if the ‘dye’ is injected into lymph channels in the foot, within a few hours X-rays will show it in the channels as far up as the groin and abdominal cavity. The next day the nodes themselves will be filled with the contrast material, sometimes right up into the chest. Their size and internal structure can then be checked. Unfortunately, because lymph nodes which are packed with cancer don’t function normally, the contrast may not get into the worst affected nodes. This can be a major drawback of this test. It is less likely to happen with lymphomas than with other types of cancer. Combining both methods by doing a CT scan after injecting the contrast actually gives the maximum information.
The biggest drawback of lymphangiography is that it can be used to show up only certain groups of nodes. Unless the nodes we want to ’see’ are fed by channels which are accessible (to have the contrast injected into them) we cannot show them up by this method.
Thus, lymphangiography cannot be used to show the lymph nodes from many of the internal organs such as the bowel, bladder, womb etc. Often it is only during an operation that we can easily find out for sure whether or not these are affected.
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