Lymphography in Childhood Cancer

Lymphographic investigations were done in 139 children (84 males and 55 females). Up to the age of 10 years the examination was performed in anesthesia; after that age suitable sedation only was given. The radiographic pattern of the lymph node involvement in this type of tumor is the same in children as in adults. Peculiar patterns were observed in neuroblastoma and in Ewing's sarcoma. 78 patients (57.4%) were suffering from systemic disease and 59 (41.9%) from solid tumors; in 2 cases the clinical diagnosis of tumor was not borne out by the histologic findings. In 35.3% of the cases with Hodgkin's disease and in 29% of supradiaphragmatic reticuloendothelial sarcoma lymphography revealed subdiaphragmatic lymph node involvement. In the stage III and IV patients lymphography was always pathologic. Pathologic lymph nodes were found in 3/10 patients with lymphoma arising in Waldeyer's tonsillar ring. Metastases were present in 40/59 of the cases of solid tumor (68.9%); the incidence of metastases was especially high in neuroblastoma (20/24), in rhabdomyosarcoma (4/5) and in tumors of the gonades (7/9). 16 cases were operated on; 2 false positives were found for lymph nodes in which there was pronounced reactive inflammatory hyperplasia.