FIGURE 5. Representative scans illustrate variable patterns of lymphatic drainage in patients with primary melanomas in different regions of body. Imaging times were between 30 and 60 min after intradermal or subdermal injection of various aliquots of 99mTc-human serum albumin nanocolloid. Upper left panel shows lymphoscintigram (anterior projection) obtained from patient who recently underwent surgery for cutaneous melanoma on elbow: Lymph flows toward single sentinel node in left axilla. Upper right panel shows lymphoscintigram (anterior projection) obtained from patient with cutaneous melanoma on right thigh (just above knee): Lymph follows at least 2 main channels converging at sentinel node in right groin. Lower left panel shows lymphoscintigram (posterior projection) obtained from patient who recently underwent surgery for cutaneous melanoma on his back (just about midline): Lymph flows through several channels toward sentinel nodes in both axillae. Right lower panel shows lymphoscintigram (posterior projection) obtained from patient who recently underwent surgery for cutaneous melanoma on his back (just left of midline): Lymph follows channels to both axillae and to right groin (visualized faintly in posterior projection because of photon attenuation through body).
