Study of the lymph flow of the cardia by endoscopic RI-lymphography with SPECT.

Endoscopic RI-lymphography was performed in 29 patients, with single photon emission computed tomography (SPECT) also performed in 19 of them. The lymph flow from the cardia was directly evaluated in lymphograms and compared with the RI uptake of each lymph node and the incidence of lymph node metastasis of previously resected carcinoma of the cardia in patients according to the location of the lymph node. Endoscopic RI-lymphography performed in combination with SPECT was considered to be highly useful for imaging lymph flow of the cardiac region. SPECT and RI-lymphography indicated rich lymph flow from the cardia to the periaortic region, and this finding was consistent with the incidence of lymph node metastasis according to the location of the lymph node in patients who had previously undergone resection of cancer of the cardia. Careful examination for metastasis to lymph nodes around the abdominal aorta was considered to be necessary, especially in patients with carcinoma of the cardia.