Radiology, Vol 122, 227-230, Copyright © 1977 by Radiological Society of North America
Upper extremity lymphangiography in the radiation therapy of lymphomas and carcinoma of the breast
TH Weisenburger and GJ Juillard
Seventeen bilateral upper extremity lymphangiograms were obtained in
patients with lymphoma referred for radiation therapy. The projection of
the opacified axillary nodes is analyzed when using the mantle technique in
various positions. The position of the lymph nodes varies considerably in
the supine and prone positions. Placing pads underneath the shoulders in
the prone position allows for better protection of the pulmonary parenchyma
while still including the opacified lymph nodes. Because these nodes vary
in position, it is recommended that if the axillary nodes are clinically
involved or if hilar adenopathy is present, upper extremity lymphangiograms
should be obtained to ensure inclusion of all the axillary lymph nodes. In
treating carcinoma of the intact breast, care should be taken to include
the lower axillary nodes in the tangenital breast field and to include 2 cm
of lung in the posterior axillary boost.
