Lymphoedema : assessment and management

This table summarizes the complex nature of lymphoedema, from its definition, classification, causes, and progression, to the methods used for its diagnosis and differentiation from other conditions. Please also refer to our chart on peripheral oedema for a better understanding of this subject.

Section	Subsection	Key Points
Lymphatic System Anatomy	Components	• Comprises initial lymphatics (capillaries), pre-collectors, collectors, lymphatic trunks, and nodes • Transports lymph containing white blood cells, triglycerides, bacteria, cell debris, water, and protein.
	Topography	• Superficial system: Drains skin and subcutaneous areas. • Deep system: Drains muscles, joints, tendon sheaths, nerves. • Both systems connected by perforating vessels.
Signs and Symptoms	General	• Distal swelling in extremities, proximal swelling in breast, chest, etc. • Restricted joint motion, skin discoloration, pain, altered sensation, limb heaviness.
	Specific Clinical Indicators	• Dryness, increased thickness, hyperkeratosis, lymphangiomas. • Warm or hot skin, unusual darkening, nodules. • Papillomatosis presenting as cobblestone skin texture.
Primary Lymphoedema	Vascular Abnormalities	• Associated with dysplasia of lymphatics, may accompany other vascular conditions like Klippel-Trenaunay-Weber syndrome, Turner syndrome. • Characterized by hyperplasia, hypoplasia, or aplasia of lymphatic vessels.
Secondary Lymphoedema	Oncologic and Surgical Causes	• Commonly due to cancer treatments, axillary lymph node dissection, radiation in the...

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