Lymph is the protein-rich fluid produced as blood passes through the tissues. Lymph collected from tissues throughout the body drains into lymphatic channels which subsequently drain into the large veins near the heart.
Along the way back to the heart, lymph passes through filtering sites called lymph nodes. Lymphedema refers to swelling in an extremity due to excess of lymph. Lymphedema can occur with overproduction of lymph, impaired removal of lymph from tissues, or loss of transport back to the heart.
Severe form of lymphedema is termed elephantiasis. Lymphedema can be complicated by infection and ulceration of the leg and in its late stage, can be a disabling condition. It is important to distinguish lymphedema as the cause of leg swelling from swelling due to venous disease because the two require different treatment modalities. Primary lymphedema refers to cases in which lymphedema develops without any known cause.
It can occur in childhood, young adulthood, or the middle ages. Secondary lymphedema refers to cases in which acquired destruction of lymphatic channels, for example, injury, infection, or cancer cause lymphedema.
This form is more common since many treatments such as surgery or radiation can interrupt the lymphatic channels. Lymphedema can be reversible or a permanent condition that will require lifelong management. Diagnosis is made by your physician from the appearance of the extremity and confirmed by a series of tests that will exclude other causes of leg swelling. Chronic lymphedema can be difficult to control or treat. Swollen limbs become vulnerable to infection. Lymphangitis appears as red streaks running up the inside of the leg and thigh and is usually accompanied by a painful swollen leg with fever and chills.
