Last reviewed: May 2019
Last updated: April  2018

Summary

Definition

History and exam

Key diagnostic factors

  • hx of malignancy
  • hx of travel to endemic filariasis area
  • hx of previous surgery
  • hx of radiotherapy
  • painless unilateral swelling of extremity or genitalia
  • involvement of distal extremity
  • positive Stemmer's sign
Full details

Other diagnostic factors

  • hx of penetrating trauma to the axilla or groin
  • limb heaviness and/or weakness
  • non-pitting oedema
  • skin changes
  • FHx of lymphoedema
Full details

Risk factors

  • breast cancer treatment
  • nematode infection (filariasis)
  • surgery near axillary or inguinal lymph nodes
  • advanced tumour, nodes, and metastasis (TNM) stage
  • radiotherapy
  • trauma
  • curvilinear scars
  • FHx of lymphoedema
  • genetic syndrome
  • obesity
Full details

Diagnostic investigations

1st investigations to order

  • lymphoscintigram
Full details

Investigations to consider

  • MRI scan of affected extremity
  • CT scan of affected extremity
  • ultrasound of affected area
  • lymphangiography
  • blood smear for filariasis
  • genetic testing
Full details

Treatment algorithm

ONGOING

all patients

Contributors

Authors VIEW ALL

Reid A. Maclellan

Department of Plastic and Reconstructive Surgery

Instructor of Surgery

Children’s Hospital Boston

Harvard Medical School

Boston

MA

Disclosures

RAM is an author of a number of references cited in this monograph.

Arin K. Greene

Department of Plastic and Reconstructive Surgery

Children's Hospital Boston

Co-director

Lymphedema Clinic

Associate Professor

Harvard Medical School

Boston

MA

Disclosures

AKG is an author of a number of references cited in this monograph.

Dr Reid A. Maclellan and Dr Arin K. Greene would like to gratefully acknowledge Dr Sumner A. Slavin and Dr Carolyn C. Schook, previous contributors to this monograph. SAS and CCS are authors of a number of references cited in this monograph.

Peer reviewers VIEW ALL

Senior Consultant Plastic Surgeon

Department of Plastic and Reconstructive Surgery

Lund University

Malmoe University Hospital

Malmoe

Sweden

Disclosures

HB is an author of a number of references cited in this monograph.

Professor

Harvard Medical School

Senior Surgeon

Children's Hospital Boston

Boston

MA

Disclosures

NRF declares that he has no competing interests.

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