Lymphography in prostatic carcinoma—implications for the diagnosis of metastases

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Abstract
Patients (42) were studied, 15 received radiotherapy and 27 were treated hormonally. Radiologically normal nodes contracted in length by a mean of 11.9% after radiotherapy and by 13.1% during hormone treatment. The average contraction of filling defects measuring 10 mm or more was significantly higher than the average contraction of normal nodes (P < 0.01 in both treatment groups), and the average contraction of the lymph nodes which contained them was also significantly higher than the average contraction of normal lymph nodes (P < 0.05 in both groups). There was no significant difference between the mean contraction of lymph nodes with filling defects measuring 2-4 mm and the mean contraction of those with filling defects measuring 5-9 mm in either treatment group. Lymph nodes with filling defects measuring 2-9 mm which were situated in patients with other lymphographic abnormalities typical of metastatic disease contracted significantly more than similar nodes which were situated in patients without these additional abnormalities (P < 0.05 in both treatment groups). Filling defects measuring 10 mm or more in diameter are usually due to metastases. There is no difference between the probability that filling defect measuring 2-4 mm and a filling defect measuring 5-9 mm is a metastasis. Filling defects measuring 2-9 mm in diameter are usually due to metastases if there is additional evidence of metastatic disease in the para-aortic or iliac nodes but not otherwise.