[Lymphography with lymph node puncture biopsy. A reliable procedure for assessing the lymphatic spread of bladder...

119 patients with bladder tumors of category Ta, Tis, T4, considered for radical treatment because of local conditions were studied by pedal lymphography (LAG) and percutaneous fine needle aspiration biopsy (FNA). 41% had a positive LAG. Adequate material was obtained for FNA in 94% of the patients. Of 70 patients with normal LAG none had a positive FNA; only 36% of those with a positive LAG had a positive FN. The high rate of positive LAG with negative FNA is attributed to inflammatory changes due to previous transurethral resection. Radical lymphadenectomy (LND) was done in 64 patients of whom 54 had a negative FNA. In this group, 8 (17%) had a positive LND. There was no mortality and morbidity was mild. LAG with FNA has a role in the pre-operative staging of bladder carcinoma.