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Linfedema

Last reviewed: 8 Apr 2025
Last updated: 08 Feb 2022

Summary

Definition

History and exam

Key diagnostic factors

  • história de malignidade
  • história de viagens a áreas com filariose endêmica
  • história de cirurgia prévia
  • história de radioterapia
  • edema indolor unilateral de membro ou genitália
  • envolvimento do membro distal
  • sinal de Stemmer positivo
Full details

Other diagnostic factors

  • história de traumatismo penetrante na axila ou na virilha
  • peso e/ou fraqueza nos membros
  • edema não depressível
  • alterações cutâneas
  • história familiar de linfedema
Full details

Risk factors

  • tratamento de câncer de mama
  • infecção por nematódeos (filariose)
  • cirurgia perto de linfonodos axilares ou inguinais
  • estádio avançado de tumor, nódulo e metástase (TNM)
  • radioterapia
  • trauma
  • cicatrizes curvilíneas
  • história familiar de linfedema
  • síndrome genética
  • obesidade
Full details

Diagnostic tests

1st tests to order

  • linfocintilografia
Full details

Tests to consider

  • ressonância nuclear magnética (RNM) do membro afetado
  • tomografia computadorizada (TC) do membro afetado
  • ultrassonografia das áreas afetadas
  • linfangiografia
  • esfregaço de sangue para filariose
  • teste genético
Full details

Treatment algorithm

ONGOING

todos os pacientes

Contributors

Authors

Reid A. Maclellan, MD, MMSc
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 topic.

Arin K. Greene, MD, MMSc
Arin K. Greene

Department of Plastic and Oral Surgery

Boston Children's Hospital

Director Lymphedema Program

Vascular Anomalies and Pediatric Plastic Surgery Endowed Chair

Professor of Surgery

Harvard Medical School

Boston

MA

Disclosures

AKG has received royalties from Springer Publishing as Editor of a lymphoedema textbook. AKG is an author of a number of references cited in this topic.

Acknowledgements

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 topic.

Disclosures

SAS and CCS are authors of a number of references cited in this topic.

Peer reviewers

Hakan Brorson, MD, PhD

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 topic.

Neil R. Feins, MD

Professor

Harvard Medical School

Senior Surgeon

Children's Hospital Boston

Boston

MA

Disclosures

NRF declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Brix B, Sery O, Onorato A, et al. Biology of lymphedema. Biology (Basel). 2021 Mar 25;10(4):261.Full text  Abstract

Manrique OJ, Bustos SS, Ciudad P, et al. Overview of lymphedema for physicians and other clinicians: a review of fundamental concepts. Mayo Clin Proc. 2020 Aug 20:S0025-6196(20)30033-1.Full text  Abstract

Executive Committee of the International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2020 Consensus Document of the International Society of Lymphology. Lymphology. 2020;53(1):3-19.Full text  Abstract

Huang TW, Tseng SH, Lin CC, et al. Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials. World J Surg Oncol. 2013 Jan 24;11:15.Full text  Abstract

Nagase T, Gonda K, Inoue K, et al. Treatment of lymphedema with lymphaticovenular anastomoses. Int J Clin Oncol. 2005 Oct;10(5):304-10. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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