Lymphography and percutaneous fine needle node aspiration biopsy in the staging of bladder carcinoma

We studied 56 patients with infiltrating bladder tumor by pedal lymphography and percutaneous fine needle node aspiration biopsy on an outpatient basis. Of 54 evaluable patients 35 (65 per cent) had a positive lymphangiogram. Adequate material for biopsy was obtained in 81 per cent of the patients. Of 15 patients with normal lymphography none had a positive aspiration, whereas 11 (32 per cent) of those with a positive lymphangiogram had a positive biopsy. The high rate of positive lymphography with negative biopsy is attributed to inflammatory changes due to previous transurethral resection of the tumor. Radical cystectomy was done in 38 patients. There were 28 negative aspirations that correlated with 21 negative lymphadenectomies and 4 positive aspirations that correlated with 4 positive lymphadenectomies. There was no mortality and morbidity was mild. Lymphography with fine needle percutaneous node aspiration biopsy has a role in the preoperative staging of bladder carcinoma.