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Lymphedema
Christopher R. McAdams, MD; Paige Bennett, MD
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Diagnostic Checklist

        TERMINOLOGY

        • Definitions

          • Abnormal accumulation of lymphatic fluid resulting in soft tissue edema secondary to impeded transport of lymph through lymphatic system

        IMAGING

        • Nuclear Medicine Findings

          • CT Findings

            • MR Findings

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    CLINICAL ISSUES

                    • Presentation

                      • Demographics

                        • Treatment

                          DIAGNOSTIC CHECKLIST

                          • Consider

                            • Image Interpretation Pearls

                              Selected References

                              1. Notohamiprodjo M et al: MR lymphangiography at 3.0 T: correlation with lymphoscintigraphy. Radiology. 264(1):78-87, 2012
                              2. Infante JR et al: Lymphoscintigraphy for differential diagnosis of peripheral edema: diagnostic yield of different scintigraphic patterns. Rev Esp Med Nucl Imagen Mol. 31(5):237-42, 2012
                              3. Balci TA et al: Gall bladder visualization in lymphoscintigraphy. Lymphat Res Biol. 10(4):208-10, 2012
                              4. Cooper KL et al: Positron emission tomography (PET) and magnetic resonance imaging (MRI) for the assessment of axillary lymph node metastases in early breast cancer: systematic review and economic evaluation. Health Technol Assess. 15(4):iii-iv, 1-134, 2011
                              5. Jensen MR et al: Lymphoedema of the lower extremities--background, pathophysiology and diagnostic considerations. Clin Physiol Funct Imaging. 30(6):389-98, 2010
                              6. Tartaglione G et al: Intradermal lymphoscintigraphy at rest and after exercise: a new technique for the functional assessment of the lymphatic system in patients with lymphoedema. Nucl Med Commun. 31(6):547-51, 2010
                              7. Kerchner K et al: Lower extremity lymphedema update: pathophysiology, diagnosis, and treatment guidelines. J Am Acad Dermatol. 59(2):324-31, 2008
                              8. Damstra RJ et al: Erysipelas as a sign of subclinical primary lymphoedema: a prospective quantitative scintigraphic study of 40 patients with unilateral erysipelas of the leg. Br J Dermatol. 158(6):1210-5, 2008
                              9. Scarsbrook AF et al: Pearls and pitfalls of radionuclide imaging of the lymphatic system. Part 2: evaluation of extremity lymphoedema. Br J Radiol. 80(951):219-26, 2007
                              10. Modi S et al: Clinical assessment of human lymph flow using removal rate constants of interstitial macromolecules: a critical review of lymphoscintigraphy. Lymphat Res Biol. 5(3):183-202, 2007
                              11. Warren AG et al: Lymphedema: a comprehensive review. Ann Plast Surg. 59(4):464-72, 2007
                              12. Barrett T et al: Imaging of the lymphatic system: new horizons. Contrast Media Mol Imaging. 1(6):230-45, 2006
                              13. Luciani A et al: Lymph node imaging: basic principles. Eur J Radiol. 58(3):338-44, 2006
                              14. Tomczak H et al: Lymphoedema: lymphoscintigraphy versus other diagnostic techniques--a clinician's point of view. Nucl Med Rev Cent East Eur. 8(1):37-43, 2005
                              15. Szuba A et al: The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. J Nucl Med. 44(1):43-57, 2003
                              16. Tiwari A et al: Differential diagnosis, investigation, and current treatment of lower limb lymphedema. Arch Surg. 138(2):152-61, 2003
                              17. Moshiri M et al: Using lymphoscintigraphy to evaluate suspected lymphedema of the extremities. AJR Am J Roentgenol. 178(2):405-12, 2002
                              18. Williams WH et al: Radionuclide lymphangioscintigraphy in the evaluation of peripheral lymphedema. Clin Nucl Med. 25(6):451-64, 2000
                              19. British Nuclear Medicine Society Protocol for Lymphoscintigraphy
                              20. Use of Lymphoscintigraphy in the Management of Chronic Oedema - Journal of Lymphoedema
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Imaging

                                • Top Differential Diagnoses

                                  • Diagnostic Checklist

                                    TERMINOLOGY

                                    • Definitions

                                      • Abnormal accumulation of lymphatic fluid resulting in soft tissue edema secondary to impeded transport of lymph through lymphatic system

                                    IMAGING

                                    • Nuclear Medicine Findings

                                      • CT Findings

                                        • MR Findings

                                          • Imaging Recommendations

                                            DIFFERENTIAL DIAGNOSIS

                                              PATHOLOGY

                                              • General Features

                                                CLINICAL ISSUES

                                                • Presentation

                                                  • Demographics

                                                    • Treatment

                                                      DIAGNOSTIC CHECKLIST

                                                      • Consider

                                                        • Image Interpretation Pearls

                                                          Selected References

                                                          1. Notohamiprodjo M et al: MR lymphangiography at 3.0 T: correlation with lymphoscintigraphy. Radiology. 264(1):78-87, 2012
                                                          2. Infante JR et al: Lymphoscintigraphy for differential diagnosis of peripheral edema: diagnostic yield of different scintigraphic patterns. Rev Esp Med Nucl Imagen Mol. 31(5):237-42, 2012
                                                          3. Balci TA et al: Gall bladder visualization in lymphoscintigraphy. Lymphat Res Biol. 10(4):208-10, 2012
                                                          4. Cooper KL et al: Positron emission tomography (PET) and magnetic resonance imaging (MRI) for the assessment of axillary lymph node metastases in early breast cancer: systematic review and economic evaluation. Health Technol Assess. 15(4):iii-iv, 1-134, 2011
                                                          5. Jensen MR et al: Lymphoedema of the lower extremities--background, pathophysiology and diagnostic considerations. Clin Physiol Funct Imaging. 30(6):389-98, 2010
                                                          6. Tartaglione G et al: Intradermal lymphoscintigraphy at rest and after exercise: a new technique for the functional assessment of the lymphatic system in patients with lymphoedema. Nucl Med Commun. 31(6):547-51, 2010
                                                          7. Kerchner K et al: Lower extremity lymphedema update: pathophysiology, diagnosis, and treatment guidelines. J Am Acad Dermatol. 59(2):324-31, 2008
                                                          8. Damstra RJ et al: Erysipelas as a sign of subclinical primary lymphoedema: a prospective quantitative scintigraphic study of 40 patients with unilateral erysipelas of the leg. Br J Dermatol. 158(6):1210-5, 2008
                                                          9. Scarsbrook AF et al: Pearls and pitfalls of radionuclide imaging of the lymphatic system. Part 2: evaluation of extremity lymphoedema. Br J Radiol. 80(951):219-26, 2007
                                                          10. Modi S et al: Clinical assessment of human lymph flow using removal rate constants of interstitial macromolecules: a critical review of lymphoscintigraphy. Lymphat Res Biol. 5(3):183-202, 2007
                                                          11. Warren AG et al: Lymphedema: a comprehensive review. Ann Plast Surg. 59(4):464-72, 2007
                                                          12. Barrett T et al: Imaging of the lymphatic system: new horizons. Contrast Media Mol Imaging. 1(6):230-45, 2006
                                                          13. Luciani A et al: Lymph node imaging: basic principles. Eur J Radiol. 58(3):338-44, 2006
                                                          14. Tomczak H et al: Lymphoedema: lymphoscintigraphy versus other diagnostic techniques--a clinician's point of view. Nucl Med Rev Cent East Eur. 8(1):37-43, 2005
                                                          15. Szuba A et al: The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. J Nucl Med. 44(1):43-57, 2003
                                                          16. Tiwari A et al: Differential diagnosis, investigation, and current treatment of lower limb lymphedema. Arch Surg. 138(2):152-61, 2003
                                                          17. Moshiri M et al: Using lymphoscintigraphy to evaluate suspected lymphedema of the extremities. AJR Am J Roentgenol. 178(2):405-12, 2002
                                                          18. Williams WH et al: Radionuclide lymphangioscintigraphy in the evaluation of peripheral lymphedema. Clin Nucl Med. 25(6):451-64, 2000
                                                          19. British Nuclear Medicine Society Protocol for Lymphoscintigraphy
                                                          20. Use of Lymphoscintigraphy in the Management of Chronic Oedema - Journal of Lymphoedema