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Liang et al. Plast Aesthet Res 2019;6:23 Plastic and
DOI: 10.20517/2347-9264.2019.33 Aesthetic Research

Review Open Access

Diagnostic workup of lymphedema

Zheng-Yun Liang, Xiao Long, Nan-Ze Yu, Jiu-Zuo Huang

Department of Plastic Surgery and Reconstructive Surgery, Peking Union Medical College Hospital, Beijing 100005, China.

Correspondence to: Dr. Xiao Long, Department of Plastic Surgery and Reconstructive Surgery, Peking Union Medical College Hospital,
Beijing 100005, China. E-mail: pumclongxiao@126.com

How to cite this article: Liang ZY, Long X, Yu NZ, Huang JZ. Diagnostic workup of lymphedema. Plast Aesthet Res 2019;6:23.
http://dx.doi.org/10.20517/2347-9264.2019.33

Received: 29 Aug 2019 First Decision: 15 Oct 2019 Revised: 23 Oct 2019 Accepted: 24 Oct 2019 Published: 30 Oct 2019

Science Editor: Raúl González-García Copy Editor: Cai-Hong Wang Production Editor: Tian Zhang

Abstract

Lymphedema is a chronic and progressive pathological state of tissue swelling caused by congenital or acquired lymphatic
abnormality. History, physical and laboratory examinations could help to diagnosis > 90% lymphedema patients. Early
stage lymphedema could be challenging to diagnose. The aim of this review is to provide an objective appraisal of current
diagnostic methods, such as lymphoscintigraphy, lympho-fluoroscopies, lymphangiography and etc. focusing on their
respective advantages and weaknesses, and hopefully shed some lights on developing a practical diagnosis modality
beneficial to early detection and clinical decision making of lymphedema.

Keywords: Lymphedema, diagnosis, lymphoscintigraphy, magnetic resonance lymphangiography, indocyanine green,
tissue dielectric constant, bioelectrical impedance spectroscopy

INTRODUCTION
Lymphedema is a pathological state of tissue swelling due to excess protein-rich fluid accumulation
in the interstitial space. The equilibrium between load of lymph fluid and transport capacity of the
lymphatics is almost invariably disturbed by either congenital dysplasia of the lymphatic system (primary
lymphedema) or acquired impairment of the lymphatic drainage (secondary lymphedema). Contrary to
all expectations, lymphedema has been reported to affect approximately 300 million people worldwide.
The incidence of primary lymphedema is 1 in 100,000 individuals with that of secondary one being is 1 in
[1]
1000 individuals . Its global impact may even be severely underestimated resulting from various diagnosis
methods and common neglect of the disease. As a chronic and progressive condition, lymphedema, if left

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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