The lymphatic spread of osteosarcoma shown by Tc-99m-MDP scintigraphy.

Osteosarcoma usually spreads via the blood stream, resulting in pulmonary and skeletal metastases. The value of bone imaging in the management of these patients is widely accepted. Less commonly, the disease spreads via the lymphatics. Such a case is reported to show that bone imaging will detect progressive involvement of the lymph nodes.