Primary upper‐limb lymphoedema
Identifieur interne : 003936 ( Istex/Corpus ); précédent : 003935; suivant : 003937Primary upper‐limb lymphoedema
Auteurs : S. Vignes ; M. Arrault ; A. Yannoutsos ; M. BlanchardSource :
- British Journal of Dermatology [ 0007-0963 ] ; 2013-02.
Abstract
Summary Background Lymphoedema is a general term used to designate pathological, regional accumulation of protein‐rich fluid. It can be either primary or secondary, and mainly occurs after cancer treatment.
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DOI: 10.1111/bjd.12024
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Yannoutsos</name><affiliation><mods:affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq‐Jay, 75015 Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Blanchard, M" sort="Blanchard, M" uniqKey="Blanchard M" first="M." last="Blanchard">M. Blanchard</name><affiliation><mods:affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq‐Jay, 75015 Paris, France</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:7A389B134574B6E403F0F9873D47945198B92F5A</idno><date when="2013" year="2013">2013</date><idno type="doi">10.1111/bjd.12024</idno><idno type="url">https://api.istex.fr/document/7A389B134574B6E403F0F9873D47945198B92F5A/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">003936</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">003936</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">Primary upper‐limb lymphoedema</title><author><name sortKey="Vignes, S" sort="Vignes, S" uniqKey="Vignes S" first="S." last="Vignes">S. Vignes</name><affiliation><mods:affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq‐Jay, 75015 Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Arrault, M" sort="Arrault, M" uniqKey="Arrault M" first="M." last="Arrault">M. Arrault</name><affiliation><mods:affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq‐Jay, 75015 Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Yannoutsos, A" sort="Yannoutsos, A" uniqKey="Yannoutsos A" first="A." last="Yannoutsos">A. Yannoutsos</name><affiliation><mods:affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq‐Jay, 75015 Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Blanchard, M" sort="Blanchard, M" uniqKey="Blanchard M" first="M." last="Blanchard">M. Blanchard</name><affiliation><mods:affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq‐Jay, 75015 Paris, France</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">British Journal of Dermatology</title><title level="j" type="alt">BRITISH JOURNAL OF DERMATOLOGY</title><idno type="ISSN">0007-0963</idno><idno type="eISSN">1365-2133</idno><imprint><biblScope unit="vol">168</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="272">272</biblScope><biblScope unit="page" to="276">276</biblScope><biblScope unit="page-count">5</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2013-02">2013-02</date></imprint><idno type="ISSN">0007-0963</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0007-0963</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Summary Background Lymphoedema is a general term used to designate pathological, regional accumulation of protein‐rich fluid. It can be either primary or secondary, and mainly occurs after cancer treatment.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>lymphoedema</json:string><json:string>lymphoscintigraphy</json:string><json:string>node</json:string><json:string>primary lymphoedema</json:string><json:string>lymphatic</json:string><json:string>cellulitis</json:string><json:string>vignes</json:string><json:string>contralateral</json:string><json:string>breast cancer</json:string><json:string>british association</json:string><json:string>deep lymphatic system</json:string><json:string>visualization</json:string><json:string>infectious complications</json:string><json:string>unilateral lymphoedema</json:string><json:string>single centre</json:string><json:string>epitrochlear node</json:string><json:string>turner syndrome</json:string><json:string>limb</json:string><json:string>lymph</json:string><json:string>syndrome</json:string><json:string>contralateral nonlymphoedematous limb</json:string><json:string>median period</json:string><json:string>axillary lymph node uptake</json:string><json:string>lymphoedema volume</json:string><json:string>general term</json:string><json:string>lymphoedematous limbs</json:string><json:string>late onset</json:string><json:string>clinical characteristics</json:string><json:string>lower limb</json:string><json:string>epitrochlear node visualization</json:string><json:string>lymphoedema management</json:string><json:string>dorsal side</json:string><json:string>regional accumulation</json:string><json:string>cancer treatment</json:string><json:string>family history</json:string><json:string>vascular anomalies</json:string><json:string>pigmentation variations</json:string><json:string>manual lymph drainage</json:string><json:string>elastic sleeve</json:string><json:string>colloidal albumin</json:string><json:string>lymphoedematous limb</json:string><json:string>popliteal node visualization</json:string><json:string>interquartile range</json:string><json:string>main characteristics</json:string><json:string>entire limb</json:string><json:string>noncongenital form</json:string><json:string>lymphoscintigraphic features</json:string><json:string>lower limbs</json:string></teeft></keywords><author><json:item><name>S. 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BJD © 2012 British Association of Dermatologists</licence></availability><date type="published" when="2013-02"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">Primary upper‐limb lymphoedema</title><title level="a" type="short">Primary upper‐limb lymphoedema</title><author xml:id="author-0000"><persName><forename type="first">S.</forename><surname>Vignes</surname></persName><affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq‐Jay, 75015 Paris, France<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0001"><persName><forename type="first">M.</forename><surname>Arrault</surname></persName><affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq‐Jay, 75015 Paris, France<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">A.</forename><surname>Yannoutsos</surname></persName><affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq‐Jay, 75015 Paris, France<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">M.</forename><surname>Blanchard</surname></persName><affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq‐Jay, 75015 Paris, France<address><country key="FR"></country></address></affiliation></author><idno type="istex">7A389B134574B6E403F0F9873D47945198B92F5A</idno><idno type="DOI">10.1111/bjd.12024</idno><idno type="unit">BJD12024</idno><idno type="toTypesetVersion">file:BJD.BJD12024.pdf</idno></analytic><monogr><title level="j" type="main">British Journal of Dermatology</title><title level="j" type="alt">BRITISH JOURNAL OF DERMATOLOGY</title><idno type="pISSN">0007-0963</idno><idno type="eISSN">1365-2133</idno><idno type="book-DOI">10.1111/(ISSN)1365-2133</idno><idno type="book-part-DOI">10.1111/bjd.2013.168.issue-2</idno><idno type="product">BJD</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">168</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="272">272</biblScope><biblScope unit="page" to="276">276</biblScope><biblScope unit="page-count">5</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2013-02"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><p><hi rend="bold">Summary</hi><hi rend="bold"> Background </hi> Lymphoedema is a general term used to designate pathological, regional accumulation of protein‐rich fluid. It can be either primary or secondary, and mainly occurs after cancer treatment.</p><p><hi rend="bold">Objectives </hi> To analyse the clinical and lymphoscintigraphic characteristics of primary upper‐limb lymphoedema (ULL).</p><p><hi rend="bold">Methods </hi> All of the patients with ULL were recruited at a single Department of Lymphology between January 2007 and December 2011.</p><p><hi rend="bold">Results </hi> In total, 60 patients (33 female, 27 male) were enrolled. For the 54 noncongenital lymphoedemas, the mean age at onset was 38·5 (range 3–82) years. Lymphoedema was unilateral in 51 patients (85%). It always affected the hand, and less often the forearm (55%) or upper arm (23%). Eleven patients (18%) developed cellulitis after onset of lymphoedema, and 21 patients (35%) had associated lower‐limb lymphoedema (LLL). Forty‐six patients (with 49 lymphoedematous limbs) underwent lymphoscintigraphy: axillary lymph node uptake was diminished in 18 (37%), absent in 24 (49%) and normal in seven limbs (14%). Among the 43 patients with unilateral lymphoedema and lymphoscintigraphy, 28 had epitrochlear node visualization, suggesting a rerouting through the deep lymphatic system, with 15 only on the lymphoedematous limb and 22 on the contralateral nonlymphoedematous limb. The median follow‐up period was 103 months, and 57/60 patients (95%) considered their lymphoedema to be stable.</p><p><hi rend="bold">Conclusions </hi> Primary ULL appears later in life than LLL, without predominance in either sex. Infectious complications are rare and patients considered the lymphoedema volume stable throughout life.</p></abstract><abstract xml:lang="en" style="short"><p><hi rend="bold">What’s already known about this topic?</hi></p><p>Primary upper‐limb lymphoedema (ULL) is a very rare disorder; no publication has specifically addressed this form.</p><p><hi rend="bold">What does this study add?</hi></p><p>This report is the first to describe the clinical and lymphoscintigraphic features of patients with primary ULL, and to discuss its differences from primary lower‐limb lymphoedema.</p></abstract><textClass><classCode scheme="tocHeading1">Original articles</classCode><classCode scheme="tocHeading2">Clinical and laboratory investigations</classCode><classCode scheme="articleCategory">CLINICAL AND LABORATORY INVESTIGATIONS</classCode></textClass><langUsage><language ident="EN"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/7A389B134574B6E403F0F9873D47945198B92F5A/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1365-2133</doi><issn type="print">0007-0963</issn><issn type="electronic">1365-2133</issn><idGroup><id type="product" value="BJD"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="BRITISH JOURNAL OF DERMATOLOGY">British Journal of Dermatology</title></titleGroup></publicationMeta><publicationMeta level="part" position="02102"><doi origin="wiley">10.1111/bjd.2013.168.issue-2</doi><numberingGroup><numbering type="journalVolume" number="168">168</numbering><numbering type="journalIssue" number="2">2</numbering></numberingGroup><coverDate startDate="2013-02">February 2013</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="11" status="forIssue"><doi origin="wiley">10.1111/bjd.12024</doi><idGroup><id type="unit" value="BJD12024"></id></idGroup><countGroup><count type="pageTotal" number="5"></count></countGroup><titleGroup><title type="tocHeading1">Original articles</title><title type="tocHeading2">Clinical and laboratory investigations</title><title type="articleCategory">CLINICAL AND LABORATORY INVESTIGATIONS</title></titleGroup><copyright>© 2012 The Authors. BJD © 2012 British Association of Dermatologists</copyright><eventGroup><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:3.1.9 mode:FullText" date="2013-01-30"></event><event agent="SPS" date="2013-01-30" type="xmlCorrected"></event><event type="publishedOnlineAccepted" date="2012-08-29"></event><event type="publishedOnlineEarlyUnpaginated" date="2012-11-20"></event><event type="publishedOnlineFinalForm" date="2013-01-30"></event><event type="firstOnline" date="2012-11-20"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:4.0.1" date="2014-03-15"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.6.4 mode:FullText" date="2015-10-02"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="272">272</numbering><numbering type="pageLast" number="276">276</numbering></numberingGroup><correspondenceTo>Stéphane Vignes.
Email: <email normalForm="stephane.vignes@cognacq-jay.fr">stephane.vignes@cognacq-jay.fr</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:BJD.BJD12024.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Accepted for publication 23 August 2012</unparsedEditorialHistory><countGroup><count type="figureTotal" number="2"></count><count type="tableTotal" number="2"></count></countGroup><titleGroup><title type="main">Primary upper‐limb lymphoedema</title><title type="shortAuthors">S. Vignes <i>et al.</i></title><title type="short">Primary upper‐limb lymphoedema</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#aff-1-1"><personName><givenNames>S.</givenNames><familyName>Vignes</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#aff-1-1"><personName><givenNames>M.</givenNames><familyName>Arrault</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#aff-1-1"><personName><givenNames>A.</givenNames><familyName>Yannoutsos</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#aff-1-1"><personName><givenNames>M.</givenNames><familyName>Blanchard</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="aff-1-1" countryCode="FR"><unparsedAffiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq‐Jay, 75015 Paris, France</unparsedAffiliation></affiliation></affiliationGroup><abstractGroup><abstract type="main" xml:lang="en"><p><b>Summary</b><b> Background </b> Lymphoedema is a general term used to designate pathological, regional accumulation of protein‐rich fluid. It can be either primary or secondary, and mainly occurs after cancer treatment.</p><p><b>Objectives </b> To analyse the clinical and lymphoscintigraphic characteristics of primary upper‐limb lymphoedema (ULL).</p><p><b>Methods </b> All of the patients with ULL were recruited at a single Department of Lymphology between January 2007 and December 2011.</p><p><b>Results </b> In total, 60 patients (33 female, 27 male) were enrolled. For the 54 noncongenital lymphoedemas, the mean age at onset was 38·5 (range 3–82) years. Lymphoedema was unilateral in 51 patients (85%). It always affected the hand, and less often the forearm (55%) or upper arm (23%). Eleven patients (18%) developed cellulitis after onset of lymphoedema, and 21 patients (35%) had associated lower‐limb lymphoedema (LLL). Forty‐six patients (with 49 lymphoedematous limbs) underwent lymphoscintigraphy: axillary lymph node uptake was diminished in 18 (37%), absent in 24 (49%) and normal in seven limbs (14%). Among the 43 patients with unilateral lymphoedema and lymphoscintigraphy, 28 had epitrochlear node visualization, suggesting a rerouting through the deep lymphatic system, with 15 only on the lymphoedematous limb and 22 on the contralateral nonlymphoedematous limb. The median follow‐up period was 103 months, and 57/60 patients (95%) considered their lymphoedema to be stable.</p><p><b>Conclusions </b> Primary ULL appears later in life than LLL, without predominance in either sex. Infectious complications are rare and patients considered the lymphoedema volume stable throughout life.</p></abstract><abstract type="short" xml:lang="en"><p><b>What’s already known about this topic?</b></p><p>Primary upper‐limb lymphoedema (ULL) is a very rare disorder; no publication has specifically addressed this form.</p><p><b>What does this study add?</b></p><p>This report is the first to describe the clinical and lymphoscintigraphic features of patients with primary ULL, and to discuss its differences from primary lower‐limb lymphoedema.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Funding sources
None.</p></note><note xml:id="fn2"><p>Conflicts of interest
None declared.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Primary upper‐limb lymphoedema</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Primary upper‐limb lymphoedema</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Primary upper‐limb lymphoedema</title></titleInfo><name type="personal"><namePart type="given">S.</namePart><namePart type="family">Vignes</namePart><affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq‐Jay, 75015 Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Arrault</namePart><affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq‐Jay, 75015 Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A.</namePart><namePart type="family">Yannoutsos</namePart><affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq‐Jay, 75015 Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Blanchard</namePart><affiliation>Department of Lymphology, Centre National de Référence des Maladies Vasculaires Rares (lymphœdèmes primaires), Hôpital Cognacq‐Jay, 75015 Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2013-02</dateIssued><edition>Accepted for publication 23 August 2012</edition><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="tables">2</extent></physicalDescription><abstract>Summary Background Lymphoedema is a general term used to designate pathological, regional accumulation of protein‐rich fluid. It can be either primary or secondary, and mainly occurs after cancer treatment.</abstract><abstract>Objectives To analyse the clinical and lymphoscintigraphic characteristics of primary upper‐limb lymphoedema (ULL).</abstract><abstract>Methods All of the patients with ULL were recruited at a single Department of Lymphology between January 2007 and December 2011.</abstract><abstract>Results In total, 60 patients (33 female, 27 male) were enrolled. For the 54 noncongenital lymphoedemas, the mean age at onset was 38·5 (range 3–82) years. Lymphoedema was unilateral in 51 patients (85%). It always affected the hand, and less often the forearm (55%) or upper arm (23%). Eleven patients (18%) developed cellulitis after onset of lymphoedema, and 21 patients (35%) had associated lower‐limb lymphoedema (LLL). Forty‐six patients (with 49 lymphoedematous limbs) underwent lymphoscintigraphy: axillary lymph node uptake was diminished in 18 (37%), absent in 24 (49%) and normal in seven limbs (14%). Among the 43 patients with unilateral lymphoedema and lymphoscintigraphy, 28 had epitrochlear node visualization, suggesting a rerouting through the deep lymphatic system, with 15 only on the lymphoedematous limb and 22 on the contralateral nonlymphoedematous limb. The median follow‐up period was 103 months, and 57/60 patients (95%) considered their lymphoedema to be stable.</abstract><abstract>Conclusions Primary ULL appears later in life than LLL, without predominance in either sex. Infectious complications are rare and patients considered the lymphoedema volume stable throughout life.</abstract><abstract>What’s already known about this topic?</abstract><abstract>Primary upper‐limb lymphoedema (ULL) is a very rare disorder; no publication has specifically addressed this form.</abstract><abstract>What does this study add?</abstract><abstract>This report is the first to describe the clinical and lymphoscintigraphic features of patients with primary ULL, and to discuss its differences from primary lower‐limb lymphoedema.</abstract><relatedItem type="host"><titleInfo><title>British Journal of Dermatology</title></titleInfo><genre type="journal">journal</genre><subject><genre>article-category</genre><topic>CLINICAL AND LABORATORY INVESTIGATIONS</topic></subject><identifier type="ISSN">0007-0963</identifier><identifier type="eISSN">1365-2133</identifier><identifier type="DOI">10.1111/(ISSN)1365-2133</identifier><identifier type="PublisherID">BJD</identifier><part><date>2013</date><detail type="volume"><caption>vol.</caption><number>168</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>272</start><end>276</end><total>5</total></extent></part></relatedItem><identifier type="istex">7A389B134574B6E403F0F9873D47945198B92F5A</identifier><identifier type="DOI">10.1111/bjd.12024</identifier><identifier type="ArticleID">BJD12024</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2012 The Authors. 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