Clinical Lymphedema

A comprehensive overview of lymphedema covering subjects as symptoms, diagnostics, research, causes and pictures
Clinical Lymphedema

Clinical lymphedema

     The clinical manifestations of lymphedema contains some general and more specific individual types and clinical forms of lymphedema.

     In the strep inflammatory lymphedema, patients have sudden onset of chills and high fever (40 degrees Celsius). Altered the general condition is often severe (headache, nausea, vomiting, sweating).

     In obstructive lymphedema, the onset is variable but often, relatively quick and the location is usually unilateral, particular to various causes (the upper limb after a radical mastectomy, the leg in patients with prostate cancer or ovary, etc.) The absence of the signs of inflammation is an important negative character.

     The early clinical lymphedema, commonly present in women around puberty is often associated with yellow nails and unequal breasts, primary pulmonary hypertension etc.

     The lymph edema is central and common. Its general characters are related to the upward development with initial involvement, usually in the foot, unilateral or bilateral and progressive enlargement within weeks, months or years across the extremities. Initially it appears and disappears during the day or weaker after prolonged rest or at night and subsequently it becomes permanent, continuing to worsen while standing. Initially soft, it can be easily depressed by pressing.

What changes should be immediately transmitted to the doctor?

     Contact your family doctor or your therapist if you have any concern, but especially if the following things occur:

  • Signs of infection - redness, warmth, rash, tenderness or pain in the affected area by lymphedema and an elevated temperature with or without flu-like symptoms.
  • Signs that you have problems with the blood circulation - changes of the color of the affected area to white, blue or a sudden increase in pain or swelling.
  • Signs of worsening of the lymphedema - growth or formation of blisters or edema, any other skin changes like strengthen of the skin for instance.
  • Signs of change perception or sensation in the area of exercise functions - tingling, numbness, pain or clumsiness.

     Your doctor or your therapist may ask you what could cause these changes and may indicate how to best address them.

Clinical lymphedema causes

     One lymphedema cause is the surgical excision of lymph nodes, usually done during cancer treatment. Normally, lymph nodes filter fluid circulating in their area, retaining bacteria, viruses and other foreign substances, which are then destroyed by special white blood cells called lymphocytes. Without the normal lymph drainage, the fluid accumulates in the arms and legs, causing lymphedema.

     Treatments like radiotherapy or trauma of the lymph nodes can also cause lymphedema. This is called secondary lymphedema. Primary lymphedema can be present at birth or can develop during puberty or adulthood. Primary lymphedema causes are unknown.

What are the cases in which clinical lymphedema can occur?

     Lymphedema can be inherited; it is hereditary, in some families there is a predisposition for its appearance. It may be caused by improper development of the lymphatic system, disease manifested by itself at birth, but sometimes discovered only later in life. When the disease occurs without a family history and without apparent cause, it is called primary lymphedema.

     Most often, lymphedema may appear after an operation or radiotherapy from the treatment of cancer. It can occur immediately after the treatment or after several years, as a result of infection or a trauma. This is called secondary lymphedema.

What causes clinical lymphedema?

     Lymphedema may occur when the lymph vessels or lymph nodes are affected as a result of cancer treatment. Following surgery or radiotherapy, scar tissue forms and the routes of lymphatic drainage of that part of the body can partially break. This situation is similar to a river on which a dam was built. Water collects behind the dam, beyond the banks of the river and if the land fails to drain the water, it's flooded. In lymphedema, lymph flow is reduced by the development of scar tissue and collects in the tissues around, causing swelling around the area.

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