Lymphoedema

Chronic, progressive swelling of tissue with protein-rich fluid as a consequence of developmental (primary lymphoedema) or acquired (secondary lymphoedema) disruption of the lymphatic system. Extremities are most commonly affected, followed by genitalia.

Most cases are secondary to nematode infection (filariasis), malignancy, or cancer-related treatment.

Typically presents with painless unilateral limb swelling; pitting oedema is present in early disease, whereas non-pitting oedema is a sensitive but non-specific finding in advanced disease.

Diagnosis is usually made on clinical grounds and confirmed by lymphoscintigraphy.

First-line treatment involves compression, ranging from static garments to complex massage and pneumatic compression devices. Surgical procedures are reserved for patients refractory to conservative measures and/or with significant morbidity.

There is no cure. Successful care requires a long-term, collaborative approach between patient and providers.

The progressive swelling of a body part, usually an extremity, following developmental (primary lymphoedema) or acquired (secondary lymphoedema) disruption of the lymphatic system resulting in lymph (a protein-rich fluid) accumulating in the interstitial space. The extremities are most commonly involved, followed by the genitalia.