Abstract
A group of 220 patients were studied by lymphangiography of the foot. Seventy-one had definite roentgenographic evidence of lymphatic flow obstruction.The altered flow dynamics of the lymphatic circulation in the presence of blockage have been analyzed and illustrated. The various lymphangiographic patterns of obstruction are: dilatation of channels; stasis of lymph flow; extravasation; backflow; and collateral circulation.Collateral circulation appears to be the most common manifestation of lymphatic obstruction and presents in 3 basic patterns: lymphatico-lymphatic, lymphaticovenous and paralymphatic.In the majority of cases, the obstruction is due to involvement of lymphatic vessels and lymph nodes by malignant neoplasms. The availability of many alternate pathways for collateral flow offers a totally unpredictable dynamic mechanism for spread of malignant disease. Benign processes produce collateral flow patterns that are indistinguishable from those secondary to malignant neoplasms.The probability of...
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