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The use and limitations of lymphography in malignant melanoma are evaluated on the basis of 116 cases, nearly all of the lower limbs, and the possibilities of use both preoperatively and during follow-up are discussed. In 53.5% of the cases lymphography revealed lymph node metastases in the inguino-iliac-lumboaortic chains, a datum that justifies the use of lymphography. Histologic examination of the lymph nodes removed at operation proved to be just as important. The two investigations agreed in 89.1% of the cases, taking the material as a whole, and in 90.5%, taking the individual lymph chains (157).

From 1967 to 1970, 94 children ranging in age from 15 months to 15 years underwent lower limb lymphography with Lipiodol Ultra Fluide. While 63.8% of patients had either Hodgkin's disease (31 cases) or lymphoreticular sarcomas (29 cases), 36.2% of the children had different types of solid tumors (32 cases). In almost every patient, the procedure was performed bilaterally and without difficulty. There were no significant side effects. Lymphograms were positive in 45.9% of the cases; some of the cases were controlled with surgery. The importance of lymphography in also determining the clinical stage in children with malignant lymphoma is emphasized. In solid tumors, the number of our patients is not yet sufficient to draw definite conclusions. However, positive lymphograms were observed in 10 of 11 patients with neuroblastoma, in 3 of 4 with rhabdomyosarcoma, and in 2 of 3 with Ewing's sarcoma. The possibility that the initial spread of these diseases could also occur through the lymphatic pathway is discussed.

The salient features of E.R.T. with Lipiodol 131I have been described by Chiappa et al. in numerous publications [6, 8].

On the basis of earlier clinical information, from September 1961 to June 1969 we have treated 426 patients by E.R.T. at the National Cancer Institute, Milan. All these patients had biopsy-proven malignant lymphomas in various stages of evolution, as follows: 208 patients with Hodgkin’s disease (HD), 95 with lymphosarcoma (LSA) and 123 with reticulum cell sarcoma (RSA).

A variety of complications and side effects have been reported by all investigators working on diagnostic lymphography and E.R.T. It is, however, evident that those caused specifically by E.R.T. should be considered separately from the others as regards their causes and importance [1–2, 6, 8–9, 13–14, 20–23, 25–26].