Primary upper-limb lymphedema.
August 2012
Vignes S, Arrault M, Yannoutsos A, Blanchard M.
Source
Department of Lymphology, Centre National de Référence des Maladies Vasculaires
Rares (lymphœdèmes primaires), Hôpital Cognacq-Jay, 75015 Paris, France.
Abstract
Background: Lymphedema is a general term applied to designate pathological regional accumulation of protein-rich fluid. It can be either primary or secondary, mainly after cancer treatment.
Objective: To analyze clinical and lymphoscintigraphic characteristics of primary upper-limb lymphedema.
Method: All patients with upper-limb lymphedema (January 2007-December 2011) recruited in a single Department of Lymphology were included.
Results: Sixty patients (33 females, 27 males) were enrolled. For the 54 noncongenital lymphedemas, mean age at onset was 38.5 (3-82) years. Lymphedema was unilateral in 51 (85%) patients. It always affected the hand, but less often the forearm (55%) or upper arm (23%). Eleven (18%) patients developed cellulitis after lymphedema onset. Twenty-one (35%) patients had associated lower-limb lymphedema. Forty-six patients (with 49 lymphedematous limbs) underwent
lymphoscintigraphy: axillary lymph-node uptake was diminished in 18 (37%), absent in 24 (49%) and normal in 7 limbs (14%). Among the 43 patients with unilateral lymphedema and lymphoscintigraphy, 28 had epitrochlear node visualization, suggesting a re-routing through the deep lymphatic system, 15 only on the lymphedematous limb and 22 on the contralateral nonlymphedematous limb. Median follow-up was 103 months and 57/60 (95%) patients considered their lymphedema stable.
Conclusion: Primary upper-limb lymphedema appears later in life than lower-limb lymphedema without sex predominance. Infectious complications are rare and patients considered the lymphedema volume stable throughout life.
PubMed
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- Pat O'Connor
- Am old enough to understand the difference between the Bay of Pigs - and roasting a pig at a epicurian feast. Been thru the hippy, yippie and yuppie years - always remaining who I am. Very much believe in "Sing your own song - weave your own tapestry" Am young enough to still know the thrill of new discoveries, the beauty of the evening, to celebrate the joy of another tommorow. Survived these many decades with a severe medical problems. Sorting out the maze of now having two lymphomas and all their nasty little companions, but I continue. Besides, being a simple iconoclastic eclectic, have been called many things. An incurable romanticist - with a strong touch of reality. Thinker, intellectual (God, how I hate that term) - been told I am a lion with the heart of the poet. Know how to wage war and conquer my foes - but would rather be known as one who brings hope and life. To bring hope into anothers life is the ultimate of joys. Life should be about bringing hope, peace, vision... a sense of purpose beyond yourself.