頸部リンパ系造影の実験的ならびに臨床的研究

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概要

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• Lymphography of the cervical lymphatic system was performed experimentally and clinically for the diagnostic purposes in the head and neck surgery.The results were as follows:1) Observations of the cervical lymphograms at different.Stages after injection of a contrast medium in dogs. The visualization of the cervical lymphatic vessels was of the most clear at 2 hours after injection and gradual disappearance was up to 24 hours thereafter. The lymph nodes were demonstrated most finely at 24 hours showing the typical homogeneous reticular patterns.2) The histopathological investigation of the cervical nodes in dogs.Upto 6 months after injection, mild nonspecific inflammatory changes occurred in the nodes due to the foreign body reaction of the contrast medium and lymphocytes were hoted to be decreasing grodually in the nodes.But after 6 months, the fatty droplets phagocytized by giant cells were eliminated, lymphocytes increased in number. At 9-12 months stage after injection, the tissues of the nodes showed normal histology.3) The fat embolism following the cervical lymphography in dogs.Although the fat embolism following the cervical lymphography in dogs may not be prevented completely, there is no risk of mentioned above following the cervical lymphography if the injection is performed with the greatest care of the volume and the speed.4) Clinical investigation of cervical lymphography.Cervical lymphography was performed in 24 patients exclusively via the single retroauricular approach.The visualizations of the normal cervical lymphatic system were made by the lymphography.In the cases sofar experienced, abnormal changes were the following:A) The passage disorder or blockage of lymphatic vesselsa) Increase of Lynphatic capillaries in number and reticular changes of lymphatic vesselsb) The changes of lymphatic vessels (rupture, dilatation, blockage, tortuosity and collateral formation)B) Abnormal changes of lymph nodesa) Moth-eaten appearanceb) Gohst-like appearancec) Homogeneous filling or non-structureC) Normal but apparently abnormal lymph nodesa) Pseudo-moth-eaten appearanceb) Central filling defectCervical lymphography is a valuable procedure for the diagnosis of malignant tumors in regions of head and neck, although it has a limited value for detecting an early small lesion of the lymphatic system.

• 社団法人 日本耳鼻咽喉科学会の論文

著者

• 野々山 純

  三重県立大学医学部耳鼻咽喉科学教室

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