Oral Exam - Lympatics and Vascular

Question 1

Lymphadema - Primary

Answer 1

Congenital or genetic causes resulting in pathologic development of lymphatic vessels
○ Congenital causes more common than genetic

Question 2

Lymphadema - Secondary causes

Answer 2

○ Typically secondary to malignant conditions &/or
treatments in developed world (most commonly breast cancer)
– Compression of lymphatics or nodes by tumor
– Infiltration of lymphatic channels by tumor cells
(lymphangitic carcinomatosis)
– Lymphadenectomy
– Radiationtherapy
○ Filariasisismostcommoncauseworldwide(nematode Wucheria bancrofti)

Question 3

Lymphadema findings

Answer 3

○ Lymphedema
– Delayed uptake of radiotracer in extremity of interest
despite exercise
– Dermal backflow (stockingsign) in extremity
– Presence of collateral &/or dilated lymphatic channels
– Interruption of lymphatic channels
– Absentor asymmetric visualization ofl ymphnodes,
lymphatic trunks

Question 4

Ddx Line infection on PET

Answer 4

Fibrin sheath

Thrombus

Question 5

Aorta uptake

Answer 5

Aortitis (giant cell, takayasu’s, mycotic aneurysm)
Endovascular stent graft (normally quite FDG avid)
Atherosclerosis
Aneurysm

Question 6

Dermal backflow ddx

Answer 6

Lymphedema
Cellulitis
Edema secondary to vascular causes

Question 7

Fibrin sheath findings

Answer 7

Focal accumuilation of tracer at tip of catheter