Linfedema

Linfedema is a chronic swelling caused by impairment of the lymphatic system, which leads to the accumulation of protein-rich fluid in the interstitial spaces. The term is used in various languages and closely corresponds to lymphedema in English. The condition can be primary, resulting from congenital or inherited lymphatic abnormalities, or secondary, caused by damage or obstruction to lymphatic vessels or nodes.

Primary lymphedema includes conditions such as Milroy disease, present at birth, and Meige disease, with later onset. Secondary lymphedema commonly arises after cancer treatment with lymph node dissection or radiation, but it can also be caused by infections (notably in tropical regions with filariasis), obesity, venous disease, trauma, or congenital malformations.

Symptoms typically include persistent swelling of an arm or leg, a feeling of heaviness or fullness, tight or thickened skin, reduced range of motion, and recurrent skin infections such as cellulitis. Skin changes may progress over time.

Diagnosis relies on clinical assessment, measurements of limb volume, and imaging studies such as lymphoscintigraphy, MRI, or CT to evaluate the lymphatic pathways. Staging ranges from 0 (latent) to III (severe swelling with skin changes).

Management aims to reduce swelling and prevent complications. First-line therapy is complete decongestive therapy, which combines manual lymph drainage, compression therapy (garments or bandages), exercise, and meticulous skin care to prevent infections. Additional measures include weight management and prompt treatment of infections. In selected cases, surgical or interventional options such as lymphatic bypass or vascularized lymph node transfer may be considered. Early diagnosis and ongoing management improve outcomes.