임파정체를 동반한 질환의 방사선학적 고찰

Abstract

[한글]

악성종양의 치료에 중요한 지침이 되는 전이의 유무를 결정하는데 있어서 임파조영술상 임파절의 형태변화와 임파유동의 변화에 따른 방사선 소견이 중요시되고 있는 차제에 저자는 1975년 10월부터 1982년 4월까지 족부임파조영술을 시행한 240례중 임파폐쇄 및 임

파정체의 양상을 보인 35례를 임파유동학적 면에서 분석하여 임상통계적으로 다음과 같은 결과를 얻었다.

1. 완전임파폐쇄는 13례, 부분임파폐쇄는 22례이었으며 이들의 속발성 방사선소견으로는 측부임파순환이 14례, 조영제의 삼출이 12례, 임파판관의 확장이 9례, 피하역류가 6례이며, 임파정체 단독소견을 보인 경우는 10례이었다.

2. 임파폐쇄의 부위로 외장골임파절부위가 17례로 가장 많았으며, 그외 서혜부임파절이하가 10례, 충장골임파절이상이 8례이었다.

3. 측부임파순환은 서혜부임파절이하부에서는 주로 피하임파관의 신생으로 형성되었으며, 외장골임파절에서는 주로 내장골임파절으로, 그리고 총장골임파절이상에서는 주로 장간막임파선과 종격동임파절으로 형성되었다.

4. 조영제의 폐전색중은 대조군에서는 175례중 12례(7%)에서 보였으나 악성종양의 전이에 의한 임파폐쇄군에서는 35례중 14례(40%)에서 발생하였다.

이상의 결과로 진행된 병기의 악성종양에 있어서 임파조영술은 임파절의 형태변화보다는 임파유동의 양상을 관찰하므로써 전이유무를 진단하는데 더욱 의의가 있다고 사료된다.

RADIOLOGICAL ANALYSTS OF DISORDERS COMBINED WITH LYMPHATIC STASIS

Tae Sub Chung, M.D.

Department of Medical Science The Graduate School, Yonsei University

(Directed by Prof. Chang Yun Park, M.D.)

The analysis of 35 cases who revealed lymphatic obstruction and lymphatic stasis

due to malignant metastasis on bipedal-lymphangiography. to evaluate the various

radiological patterns of lymphatic obstruction and pathophrsiologic mechanisms due

to lymphatic obstruction, from Oct. 1975 to Apr. 1952 at YUMC Hospital was

undertaken and the following results were obtained.

1. of these, 12 had complete lymphatic obstruction and 22 partial lymphatic

obstruction on lymphangiography. There was lymphatic collateral circulation in 14,

extravasation of contrast media in 12, lymphatic dilatation in 9, dermal backflow

in 6, and only lymphatic stasis in 10.

2. According to the level or location of lymphatic obstrution, there were 17 at

external iliac lymph nodes, 10 below the inguinal lymph nodes, and 8 above the

common iliac lymph nodes.

3. Lymphatic collateral circulation was developed mainly by neoformation of

subcutaneous lymphatics below the inguinal lymph nodes obstruction, collateral flow

into the internal iliac lymphatics at external iliac lymph nodes obstruction,

collateral flow into the mesenteric and mediastinal lymphatics above the common

iliac lymph nodes obstruction.

4. Pulmonary oil embolism was developed in 12 of 175 (7%) in control group, but

in 14 of 35 (40%) in lymphatic obstruction group.

Finally, the dynamic evaluation of lymphatic flow on lymphan-giography is more

important than the morphologic evaluation of lymph nodes in advanced malignant

disease.

[영문]

The analysis of 35 cases who revealed lymphatic obstruction and lymphatic stasis due to malignant metastasis on bipedal-lymphangiography. to evaluate the various radiological patterns of lymphatic obstruction and pathophrsiologic mechanisms due

to lymphatic obstruction, from Oct. 1975 to Apr. 1952 at YUMC Hospital was undertaken and the following results were obtained.

1. of these, 12 had complete lymphatic obstruction and 22 partial lymphatic obstruction on lymphangiography. There was lymphatic collateral circulation in 14, extravasation of contrast media in 12, lymphatic dilatation in 9, dermal backflow in 6, and only lymphatic stasis in 10.

2. According to the level or location of lymphatic obstrution, there were 17 at external iliac lymph nodes, 10 below the inguinal lymph nodes, and 8 above the common iliac lymph nodes.

3. Lymphatic collateral circulation was developed mainly by neoformation of subcutaneous lymphatics below the inguinal lymph nodes obstruction, collateral flow into the internal iliac lymphatics at external iliac lymph nodes obstruction, collateral flow into the mesenteric and mediastinal lymphatics above the common iliac lymph nodes obstruction.

4. Pulmonary oil embolism was developed in 12 of 175 (7%) in control group, but in 14 of 35 (40%) in lymphatic obstruction group.

Finally, the dynamic evaluation of lymphatic flow on lymphan-giography is more important than the morphologic evaluation of lymph nodes in advanced malignant disease.