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December 25, 1967

Lymphangiography by Lymph-Node Injection

JAMA. 1967;202(13):1136-1139. doi:10.1001/jama.1967.03130260058010

Lymphangiography, introduced by Kinmonth1 of England in 1955, is becoming increasingly important in diagnosis and treatment of malignant disease.2 Because Kinmonth's technique, which involves cannulation of a tiny lymphatic channel in the foot, is occasionally difficult and often timeconsuming, use of lymphangiography has been somewhat restricted. For this reason injection of lymph nodes has been developed as an alternate and simplified technique.

Since lymph must flow through nodes in order to circulate, lymph nodes can be considered to be intermittent dilations of lymphatic vessels. Although there is some difference of opinion3 most anatomists agree that there are no endothelial-lined channels through nodes; rather, lymph seeps between cells which are suspended in a reticular, cobweb-like mesh. Flow generally follows the path of least resistance through the coarse mesh with its suspended reticuloendothelial cells.4 Thus a needle introduced anywhere within the capsule of a lymph node is in