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Lymph nodes play an important role in the immune system. They help store white blood cells that fight infection. They also trap cancer cells.
Lymph nodes are located throughout your body. A network of lymph vessels connects them. These vessels carry fluid containing white blood cells in and out of the lymph nodes. This fluid is called lymph.
Lymph nodes and lymph vessels don’t normally show up on an X-ray. You need a special procedure called a lymphangiogram to see them.
If you have cancer, your healthcare provider may use a lymphangiogram to see whether the cancer has spread to other parts of your body.
You’ll probably also need a lymph node biopsy. Your doctor will remove either an entire lymph node or a small sample to check for cancer cells.
Not all lymphangiograms are related to cancer. Your doctor may perform one to diagnose swelling in your arm or leg. The procedure may also be used to diagnose parasitic diseases, such as filariasis.
Tell your doctor if you’re pregnant. The radiation from X-rays may be more problematic for pregnant women. Also, be sure to tell your doctor if you’ve ever had:
Your doctor may ask you to fast for several hours before the test. Your doctor will provide specific instructions.
You’ll sit down, and the person performing the procedure will clean your feet. A blue dye called contrast will be injected into the webbing between the first and second toes on each foot. This is not the actual test. It’s just used to locate your lymph channels. After a few minutes, the dye will turn your lymph channels blue.
Your doctor will select one of the larger lymph channels and numb the area. They’ll make a small cut and then insert a tube into the channel. The process will be repeated on the other foot. Once both tubes are in place, more contrast dye will be slowly injected.
Unlike the lymphatic system itself, the dye is visible on X-ray images. Your doctor can use X-rays to follow the path of the dye throughout your lymphatic system. This can help detect blockages or swollen lymph nodes.
You may need to return the day after your procedure for more X-rays.
You will typically receive stitches to close the cuts on each foot. You can expect to feel some pain and soreness in the area.
Don’t be alarmed if your skin appears blue for a day or two after the procedure. This is normal. It’s also normal for your vision to turn blue for about two days. Your urine and stool will be discolored as well.
Any time you have an X-ray, you receive some low-level radiation exposure. These levels of radiation are generally considered safe. Radiation may be more problematic for children and pregnant women. Even so, the risk of damage to the fetus during an X-ray is low.
There are also risks associated with the dye used in the procedure. It can sometimes cause:
Abnormal results mean that a lymph vessel is blocked or a node is swollen. This could be caused by cancer, infection, injury, or previous lymphatic surgery.
Don’t try to interpret your results on your own. Talk to your doctor. Abnormal results may have many causes and not all of them are scary.
Written by: Gretchen Holm
Medically reviewed on: Feb 08, 2016: George Krucik, MD, MBA
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