Lymphedema is the swelling of soft tissue as a result of the
accumulation of protein rich fluid in the extra cellular spaces. It occurs most
frequently in an extremity but can be seen in the head, neck, abdomen, and
Types of Lymphedema:
There are two types of lymphedema.
Primary lymphedema occurs without any known precipitating
cause, and is due to inadequate or non-functional lymphatic vessels. Primary
lymphedema present at birth is called congenital lymphedema. Lymphedema praecox
evolves in adolescence or mid-life. Lymphedema tarda evolves late in life.
Secondary lymphedema is precipitated by an event causing
blockage or interruption of the lymphatic vessels. In the United States the
most common causes are surgery involving the lymph nodes, radiation therapy,
trauma, and cancer. It is most often seen following surgery for cancer of the
breast, pelvic area, and resections for lymphomas and melanomas.
Symptoms of Lymphedema:
As lymphedema progresses the involved areas swell more and
more. Mobility can be severely impaired as the affected areas increase in
girth. Joint movement is restricted and painful, and the skin over the involved
areas becomes taut and dry. The subcutaneous tissues can become hard and
fibrotic which impairs the flow of blood and oxygen to the area. This unhealthy
state often leads to recurrent infections because the high protein lymph fluid is a good
growth media for bacteria and fungi. These infections can be life threatening
and may require hospitalization for intravenous antibiotic therapy. Each
subsequent infection can further damage the already impaired lymph system.