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(Primary Lymphedema; Secondary Lymphedema)

Definition

Lymphedema is swelling in the tissues. It occurs when the lymph system is not working well. The lymph system is made of organs, vessels, nodes, and fluids. It is part of the immune system.

There are two types:

  • Primary
  • Secondary
Damaged Lymph Nodes
damaged lymph
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Causes

Primary lymphedema is caused by defects of the nodes or vessels. It is due to a birth defect or change in genes. It is found in conditions such as:

  • Milroy’s disease
  • Meige disease

Secondary lymphedema is caused by conditions that block the flow of fluid. Examples are:

  • Infection
  • An abnormal growth in the area
  • Medical conditions
  • Medical treatments—such as removal of lymph nodes
  • Injury
Planned Lymph Removal for Cancer Treatment
lymph nodes to be removed
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Risk Factors

Things that raise the risk are:

  • Surgery that includes the removal of lymph nodes
  • Cancer and radiation for cancer
  • Infections
  • Rheumatoid arthritis
  • Blood vessel problems
  • Burns
  • Obesity
  • Immobility

Symptoms

Symptoms of lymphedema include:

  • Swelling in arms, legs, fingers, or toes
  • Clothes, shoes, or jewelry may feel tight—not due to weight change
  • Heaviness in one or more limbs
  • A feeling of tightness, hardening, or reddening of the skin
  • Loss of flexibility in nearby joints
  • Aching, pain, discomfort, or tingling in the limb

Lymphedema can also lead to problems such as:

  • Breakdown of the skin
  • Infections of the skin
  • Changes in the size and shape of the limb

Diagnosis

The doctor will ask about your symptoms and health past. A physical exam will be done. Lymphedema may be diagnosed based on the exam.

If the cause is unclear, more tests may be needed, including blood tests. Images may be taken such as:

Treatment

Treatment depends on the cause. Options may be:

Prevention

The risk may be lowered by managing health problems that cause lymphedema. Early treatment can make a big difference.

RESOURCES

National Cancer Institute  https://www.cancer.gov 

National Lymphedema Network  https://www.lymphnet.org 

CANADIAN RESOURCES

Canadian Cancer Society  http://www.cancer.ca 

Lymphedema Association of Quebec  http://www.infolympho.ca 

References

Borman P. Lymphedema diagnosis, treatment, and follow-up from the view point of physical medicine and rehabilitation specialists. Turk J Phys Med Rehabil. 2018 Sep; 64(3): 179–197.

Lymphedema—approach to the patient. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/lymphedema-approach-to-the-patient . Accessed January 18, 2021.

Lymphedema. Society for Vascular Surgery website. Available at: https://vascular.org/patient-resources/vascular-conditions/lymphedema. Accessed January 18, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
  • Review Date: 02/2020
  • Update Date: 01/18/2021