Lymfedema

Lymfedema, commonly referred to in English as lymphedema, is a long-term condition characterized by swelling caused by impaired function of the lymphatic system. It results from insufficient drainage of lymph fluid, leading to accumulation in the interstitial tissues. Lymphedema can be primary, due to congenital abnormalities of lymphatic vessels or nodes, or secondary, arising from injury or diseases that damage the lymphatic system.

Primary lymphedema includes congenital or hereditary forms that may present in childhood or puberty, while secondary lymphedema is more common and often linked to cancer treatment (removal of lymph nodes or radiation), infections such as filariasis, trauma, venous insufficiency, or obesity. The condition typically affects one limb (often the legs) but can involve any body region.

Symptoms include swelling, a feeling of heaviness or fullness, and reduced flexibility of the affected limb. The skin may become tight or thickened over time, and patients are prone to recurrent infections such as cellulitis. In early stages the swelling may be soft and improve with elevation, while advanced stages may be more persistent and non-pitting.

Diagnosis relies on clinical examination and measurement of limb volume or circumference, complemented by imaging studies to assess lymphatic flow. Techniques such as lymphoscintigraphy or indocyanine green (ICG) lymphography, as well as ultrasound or bioimpedance spectroscopy, may aid in confirming the diagnosis and determining stage.

Management is typically lifelong and multidisciplinary. Goals are to reduce swelling, prevent infections, and preserve function. Treatments include compression therapy, manual lymphatic drainage performed by trained therapists, regular exercise, meticulous skin care, and weight management. In some cases pneumatic compression devices are used. When conservative measures are insufficient, surgical options such as lymphatic bypass, lymph node transfer, or liposuction may be considered. Diuretics are generally not effective for lymphedema. Early recognition and ongoing care improve outcomes.