Lymphoscintigraphy of the Lower Extremities Discrepancies Between Superficial and Deep Lymphatic Systems

We describe a 57-year-old man with prostate cancer. A radical prostatectomy with a pelvic lymphadenectomy was performed. After 2 years, a mild swelling of the lower extremities appeared, and the patient was referred for lower-limb lymphoscintigraphy. A lymphoscintigraphy of the superficial lymphatic system in the limbs showed prominent, dermal backflow in the area of the right hypogastrium. Lymphoscintigraphy of the deep lymphatic system showed reflux in the left hypogastrium. This discrepancy between the findings in the superficial and deep lower-limb lymphatic systems was explained by asymmetric sampling of the lymph nodes during the lymphadenectomy.

Automated summary

We report a case of a 57-year-old man with prostate cancer who underwent radical prostatectomy and pelvic lymphadenectomy. Two years later, the patient presented with mild lower limb swelling and underwent lower limb lymphoscintigraphy. The lymphoscintigraphy showed prominent dermal backflow in the area of the right hypogastrium in the superficial lymphatic system, and reflux in the left hypogastrium in the deep lymphatic system. This discrepancy in findings can be explained by asymmetric sampling of the lymph nodes during the lymphadenectomy.