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February 27, 1967

Direct Magnification Lymphography

Author Affiliations

From the Department of Radiology, Yale University School of Medicine, New Haven, Conn. Dr. Ditchek is presently at the University of Michigan Medical Center, Ann Arbor.

JAMA. 1967;199(9):654-656. doi:10.1001/jama.1967.03120090096019

Lymphography has j gained widespread acceptance as a method of diagnosing disease in abdominal and pelvic lymph nodes. However, the diagnostic accuracy of this procedure in neoplastic disease leaves much to be desired. Recent publications1,2 have emphasized that a positive lymphographic diagnosis of neoplasm in the nodes may be confirmed histologically by 85% to 90% of cases. In cases with lymphograms not demonstrating neoplastic abnormalities, histologic examination will concur in only 65%. With regard to "false-positive" interpretations, normal variations in nodal architecture and fatty or fibrous filling defects may be misinterpreted.3 With regard to "falsenegative" findings, actual neoplastic deposits in nodes may be too small for reliable detection.

Because of these limitations, it was felt that a magnification technique would yield better definition of lymph node structure. Photographic enlargement of conventional x-ray films, however, fails to accomplish this because of the accompanying enlargement of penumbra effect and motion