Lymphatic Disorders 2018-04-05T16:37:31+00:00

What is Lymphedema?

Lymphedema is a condition in which an excessive amount of lymph (liquid with some solid parts) collects in one place in the body, causing edema (swelling) and later if not properly treated, skin problems. Lymphedema occurs most frequently in the arms and legs. Lymphedema is most often a chronic condition and rarely cured, but it can generally be controlled by carefully following a treatment program.

Types of Lymphedema

Primary Lymphedema

Primary Lymphedema occurs when the development of lymph vessels and/or lymph nodes is abnormal. This condition may be present at birth, but may only show up as edema at the time of puberty or even later in life. Primary lymphedema is much more common in women and occurs most often in the legs. A significant number of patients with primary lymphedema (perhaps as many as 10%) are thought to have chronic reflux (back flow of lymph fluid in the lymph vessels). This includes patients with congenital lymphatic hyperplasia, which in its most extreme form is sometimes known as “megalymphatic” disease. There are 3 types of primary lymphedema. Congenital lymphedema presents at birth and accounts for about 10% of all cases. Lymphedema praecox shows up between the ages of 2 and 25 years old and represents about 80% of all primary lymphedema. Finally, lymphedema tarda is generally noted first after the age of 35 and accounts for 10% of these cases.

Secondary Lymphedema

Secondary Lymphedema has 2 causes. The first is obstruction or blockage of lymph fluid movement in the lymph vessels or nodes. The cause can be injury, infection, blockage from tumor invasion, radiation therapy, or by surgical removal or damage of the lymph nodes or lymph vessels. Surgical damage of the lymph system may be the most common cause in the United States. Scarring of the lymph vessels or nodes is the final result of most causes. The most common cause of lymphedema world wide is filarial disease, caused by infecting worms. These are parasites (worm type invaders) that get into the patient and damage the lymph vessels as well as causing other problems. The world health organization estimates that the number of people affected worldwide by this problem may approach 100 million. A less common cause of lymphedema is overproduction of interstitial / lymphatic fluid, the second cause of secondary lymphedema. High body temperature, injury or inflammation (infection) are thought to produce lymphedema by this mechanism. Most of these conditions resolve in time and so does the lymphedema. Chronic overload occurs when the lymphatic system is repeatedly damaged over time due to recurrent infections, chronic vein problems, or obesity. These types of overload to the lymphatic system can cause lymphedema to progress more quickly.

Signs and Symptoms

  • Swelling of part or all of your arm or leg, including fingers or toes.

  • A feeling of heaviness or tightness.

  • Restricted range of motion.

  • Aching or discomfort.

  • Recurring infections.

  • Hardening and thickening of the skin (fibrosis).

Diagnosis

  • Physical Exam

  • MRI (Magnetic resonance imaging)

  • CT Scan

  • Doppler Ultrasound

  • Lymphoscintigraphy

  • Lymphangiography

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