A four-day postpartum patient with oat cell carcinoma of the lungs and mediastinum developed blindness, right hemiparesis, and was comatose shortly after undergoing lymphangiography. She made a full recovery from the effects of the procedure over the next week.
Only 19 cases of cerebral complications following lymphangiography have been recorded in the world literature, and this is the second case of blindness reported. Ethiodized oil (Ethiodol) could reach the cerebral circulation (1) during compression or obstruction of the caval system, (2) through lymphovenous shunts, either congenital or tumor-induced, (3) through a right-to-left intracardiac shunt, or (4) via intrapulmonary arteriovenous shunts which can occur with acute and chronic pulmonary disease—probably the mechanism of cerebral embolization of dye in our patient.
Jay JC, Ludington LG. Neurologic Complications Following LymphangiographyPossible Mechanisms and a Case of Blindness. Arch Surg. 1973;106(6):863-864. doi:10.1001/archsurg.1973.01350180095027