Lymphographie Und Tumordiagnostik
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Wer sich mit Biologie, Diagnostik und Therapie der malignen Tumoren befaBt, muBte es als schweren Mangel empfinden, daB unsere Aussagen iiber den Tumor- befall des Lymphsystems auBerst unsicher waren und eine objektive Methode mit breiter Anwendungsbasis fehlte. Es war bekannt, daB bei negativem palpatorischem Befund in einem erheblichen Bruchteil histologisch tumorbefallene Lymphknoten vorlagen, und man muBte sich bei zahlreichen Lymphknotengruppen, vor allem den abdominellen, bei der klinischen Untersuchung einer Aussage iiberhaupt enthalten. Vielfache Versuche, diese diagnostische Liicke auszufiillen, erwiesen sich bisher als ungeniigend und waren nicht ungefahrlich. Die Kontrastmitteldarstellung, als potentiell aufschluBreichsteMethode, entsprach schon lange einem dringenden Bediirfnis. Aber erst die Sichtbarmachung der LymphgefaBe im Rontgenbild durch intralymphatische Injektion geeigneter KontrastmittellieB die Lymphographie zu einer brauchbaren Methode werden, die sich im Laufe kiirzester Zeit an vielen Kliniken einfiihrte. Jede neue Methode muB eine Entwicklungsphase durchlaufen. Diese abkiirzen zu helfen, und allen denjenigen, die die neue Methode anwenden, die Anfangsversager zu ersparen, ist ein Hauptanliegen dieser DarstellUng. Sehr ausfiihrlich, ja fast pedantisch wird die Untersuchungstechnik dargesteHt und, wie mir scheint, sehr wohl begriindet, weil ein gutes diagnostisches Ergebnis noch mehr als bei andern radiologischen Verfahren eine ausgefeilte Untersuchungstechnik zur V oraussetzung hat. Auch die Gefahrdung des Patienten laBt sich, bei Beachtung der hier beschriebenen moglichen, aber meist voraussehbaren ZwischenfaHe, prak- tisch auf ein auch vielen anderen Routineverfahren inherentes Minimum redu- zieren.
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