Bilateral axillary lymph node uptake of radiotracer during lower extremity lymphoscintigraphy

Lymphoscintigraphy is a useful technique for the evaluation of lymphatic function in the presence of limb swelling. The authors report a case where proximal lower limb and genital swelling in a 23-yr-old man was investigated by lymphoscintigraphy. The patient had a history of previous surgery and subsequent infection in the affected groin. Lower limb lymphoscintigraphy showed features of an unusual lymphatic drainage pattern that most likely represented adaptation to chronic lymphatic insufficiency. The drainage pattern was characterized by marked dermal backflow pattern, aberrant lymph node uptake in the abdomen and chest and unexpected avid radiotracer uptake in the axillae bilaterally.