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Lymphocele: The Spectrum of Scintigraphic Findings in Lymphoceles Associated with Renal Transplant

Nuclear Medicine Service, Fitzsimons Army Medical Center, Aurora, Colorado
Nuclear Medicine Service, Walter Reed Army Medical Center, Washington, DC
The Uniformed Services, University of the Health Sciences, Bethesda, Maryland

Correspondence: For reprints contact: Edwin J. Fortenbery, CPT, MC, Nuclear Medicine Service, Fitzsimons Army Medical Center, Aurora, CO 80045-5001.

ABSTRACT

Lymphocele is a well recognized complication of renal transplant surgery. We performed a retrospective review of 305 renal transplant patients with over 2,500 scintigraphic exams to describe the pattern of activity on technetium-99m-DTPA blood flow and dynamic imaging, and iodine-131-OIH studies. Diagnostic criteria for a lymphocele were ultrasonic evidence of a perirenal fluid collection and analysis of that fluid that demonstrated BUN, creatinine, and electrolytes similar to the patient's plasma. Scintigraphic findings were attributed to a lymphocele if abnormalities were in the same area as the ultrasound fluid collection. Scintigraphic findings attributable to lymphocele resolved in all patients following surgical drainage or peritoneal window placement. Six of the 11 documented lymphoceles demonstrated a cold defect on initial dynamic images that "filled in" to equal background activity and another exceeded background. Three cases showed a rim of increased activity surrounding the lymphocele ("rim sign").

FOOTNOTES

Disclaimer: The opinions and assertions contained herein are the private views of the authors and are not to be construed as reflecting the views of the Army or the Department of Defense.