lymphostasis

Lymphostasis is stagnation of lymphatic fluid within the lymphatic system, resulting from reduced propulsion or obstruction of lymph flow. It leads to accumulation of protein-rich lymph in interstitial tissue and is a central mechanism in lymphedema, often presenting as swelling with heaviness, skin changes, and infection risk.

Causes include primary lymphostasis from congenital lymphatic abnormalities, and secondary forms due to cancer surgery, radiation, infection (notably filariasis), trauma, obesity, or persistent venous insufficiency.

Pathophysiology involves elevated lymphatic pressure and impaired drainage, with edema that may become non-pitting and fibrotic over time; patients are prone to recurrent infections and reduced limb function.

Diagnosis relies on history and exam, supported by imaging such as lymphoscintigraphy or indocyanine green lymphography.

Management aims to reduce lymph accumulation: complete decongestive therapy with manual lymph drainage, compression garments, exercise, and skin care; infection prevention; and, in refractory cases, surgical options such as lymphaticovenular anastomosis or vascularized lymph node transfer at specialized centers.

Prognosis is variable and generally chronic; early treatment improves outcomes and quality of life, while ongoing management reduces infection risk.