THE VARIABLE FATE OF OILY CONTRAST MEDIA AFTER LYMPHOGRAPHY COMPARED WITH RESIDUES IN OTHER SITES

¹ From the Departments of Pathology, Vancouver General Hospital and the University of British Columbia, and the Department of Radiology, St. Paul's Hospital, Vancouver, British Columbia, Canada

Oily lymphangiographic contrast media provoke unsuspectedly rapid histiocytic cocooning reactions in lymph nodes. This appears to be the main factor which prevents flow of the medium very shortly after introduction, rather than viscosity. Experimentally, similar cell reactions can be detected within minutes in lymph nodes. In this series it was detectable at 8 hours and very evident at 2 days.

The histiocytic reaction to lymphangiographic media appears to be unlike the ordinary process of phagocytosis in lymph nodes. It has features suggesting a form of encystment rather than true intracytoplasmic incorporation. Such a syncytial cell shield seems to block lipolysis, and effectively traps media. It vanishes around the eighth month when radiographic resolution begins.

Although often visualized during lymphangiography, the cisterna chyli and thoracic duct do not opacify persistently. Contrast medium reaching the lungs appears to vanish after minutes. This is thought to be due to dispersion into droplet size below the limits of radiographic resolution. There is much evidence that it persists for weeks, and, unlike the contrast medium trapped in lymph nodes, undergoes a continuous lipolytic disintegration.

A comparison with persistences and cell trapping in other tissues is given.

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