Lymphoscintigraphy in paediatric and adolescent patients

Lymphoscintigraphy has emerged as the diagnostic test of choice differentiating lymphoedema from other causes of extremity swelling in adult and paediatric patients with a high clinical suspicion of impaired lymphatic function. In paediatric patients who present with lymphoedema, primary lymphoedema accounts for the majority of the cases, with prevalence estimates that approximate 1.15/100,000 persons aged less than 20 years. Other causes of lymphoedema include combined lymphatic vascular diseases and to a lesser extent, secondary lymphoedema due to surgical and non-surgical trauma to the lymphatic system. Lymphoscintigraphy plays an important role in the direction of clinical management in these patients with lymphoedema and proper recognition of lymphoscintigraphic patterns in this population is essential. Sentinel lymph node localization and biopsy has become standard of care in adult patients with melanoma and breast cancer. It is recommended in paediatric and adolescent patients with melanoma, peripheral rhabdomyosarcomas, and several specific soft tissue sarcomas.