Abstract
Since 1961, 285 cases of testicular neoplasms have been investigated by means of lymphangiography at the National Cancer Institute of Milan. Bilateral foot lymphangiography was performed in 233 cases, 46 patients had combined funicular and foot lymphangiography, and in 6 only funicular lymphangiography was performed. Lymphangiograms were probative for secondaries in the retroperitoneal lymph-nodes in 162 cases (56.8 %). The most frequent site of metastasis was the para-aortic nodes (154 cases) with bilateral involvement in 68. Funicular lymphangiograms showed metastasis in the primary testicular lymph-centre in 28/52 investigated cases, and in 6 this was the only site of metastasis. These lymph-nodes are not visualized by foot lymphangiography. Radiological investigations other than lymphangiography were performed in 236 instances. I.V.P. was unable to visualize involved but not enlarged lymphnodes, but proved to be useful in defining the extent of large metastases. G.I.T. was performed in 59 cases and in 4 instances showed retrogastric metastases, which were not visualized by lymphangiography. Also R.P.P. visualized high retroperitoneal metastases in 2 cases with negative lymphangiograms. V.I. were positive only in far advanced cases. Histological lymphographic correlation was possible in 61 cases. Sensitivity (% correct positive lymphangiograms) was 96 % and specificity (% correct negative tests) was 89 %. False negative lymphangiograms occurred only in previously operated patients. In these cases only foot lymphangiography may be performed and the primary testicular lymph-center cannot be visualized.
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