Lymphoedema of the lower extremities--background, pathophysiology and diagnostic considerations.
Identifieur interne : 003D13 ( Ncbi/Merge ); précédent : 003D12; suivant : 003D14Lymphoedema of the lower extremities--background, pathophysiology and diagnostic considerations.
Auteurs : Mads R. Jensen [Danemark] ; Lene Simonsen ; Tonny Karlsmark ; Jens BülowSource :
- Clinical physiology and functional imaging [ 1475-097X ] ; 2010.
Descripteurs français
- KwdFr :
- Facteurs de risque, Homéostasie, Humains, Lymphoedème (imagerie diagnostique), Lymphoedème (physiopathologie), Lymphoedème (étiologie), Lymphoscintigraphie, Membre inférieur (imagerie diagnostique), Membre inférieur (physiopathologie), Pression hydrostatique, Radiopharmaceutiques (administration et posologie), Système lymphatique (physiopathologie), Valeur prédictive des tests.
- MESH :
- administration et posologie : Radiopharmaceutiques.
- imagerie diagnostique : Lymphoedème, Membre inférieur.
- physiopathologie : Lymphoedème, Membre inférieur, Système lymphatique.
- étiologie : Lymphoedème.
- Facteurs de risque, Homéostasie, Humains, Lymphoscintigraphie, Pression hydrostatique, Valeur prédictive des tests.
English descriptors
- KwdEn :
- Homeostasis, Humans, Hydrostatic Pressure, Lower Extremity (diagnostic imaging), Lower Extremity (physiopathology), Lymphatic System (physiopathology), Lymphedema (diagnostic imaging), Lymphedema (etiology), Lymphedema (physiopathology), Lymphoscintigraphy, Predictive Value of Tests, Radiopharmaceuticals (administration & dosage), Risk Factors.
- MESH :
- chemical , administration & dosage : Radiopharmaceuticals.
- diagnostic imaging : Lower Extremity, Lymphedema.
- etiology : Lymphedema.
- physiopathology : Lower Extremity, Lymphatic System, Lymphedema.
- Homeostasis, Humans, Hydrostatic Pressure, Lymphoscintigraphy, Predictive Value of Tests, Risk Factors.
Abstract
Lymphoedema of the lower extremities is a chronic debilitating disease that is often underdiagnosed. Early diagnosis and treatment is paramount in reducing the risk of progression and complications. Lymphoedema has traditionally been defined as interstitial oedema and protein accumulation because of a defect in the lymphatic drainage; however, some findings suggest that the interstitial protein concentration may be low in some types of lymphoedema. Primary lymphoedema is caused by an inherent defect in the lymphatic vessels or lymph nodes. Secondary lymphoedema is caused by damages to the lymphatic system most often caused by cancer or its treatment. Many of the underlying pathophysiological mechanisms have yet to be elucidated. Many methods have been developed for examination of the lymphatic system. Lymphoscintigraphy is presently the preferred diagnostic modality. Lack of consensus regarding protocol and qualitative interpretation criteria results in a too observer dependent outcome. Methods for objectifying the scintigraphy through quantification have been criticized. Depot clearance rates are an alternative method of quantification of lymphatic drainage capacity. This method however has mostly been applied on upper extremity lymphoedema. The aim of this review is to provide a literature-based overview of the aetiology and pathophysiology of lower extremity lymphoedema and to summarize the current knowledge about lymphoscintigraphy and depot clearance techniques. The abundance of factors influencing the outcome of the examination stresses the need for consensus regarding examination protocols and interpretation. Further studies are needed to improve diagnostic performance and understanding of pathophysiological mechanisms.
DOI: 10.1111/j.1475-097X.2010.00969.x
PubMed: 20718809
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Early diagnosis and treatment is paramount in reducing the risk of progression and complications. Lymphoedema has traditionally been defined as interstitial oedema and protein accumulation because of a defect in the lymphatic drainage; however, some findings suggest that the interstitial protein concentration may be low in some types of lymphoedema. Primary lymphoedema is caused by an inherent defect in the lymphatic vessels or lymph nodes. Secondary lymphoedema is caused by damages to the lymphatic system most often caused by cancer or its treatment. Many of the underlying pathophysiological mechanisms have yet to be elucidated. Many methods have been developed for examination of the lymphatic system. Lymphoscintigraphy is presently the preferred diagnostic modality. Lack of consensus regarding protocol and qualitative interpretation criteria results in a too observer dependent outcome. Methods for objectifying the scintigraphy through quantification have been criticized. Depot clearance rates are an alternative method of quantification of lymphatic drainage capacity. This method however has mostly been applied on upper extremity lymphoedema. The aim of this review is to provide a literature-based overview of the aetiology and pathophysiology of lower extremity lymphoedema and to summarize the current knowledge about lymphoscintigraphy and depot clearance techniques. The abundance of factors influencing the outcome of the examination stresses the need for consensus regarding examination protocols and interpretation. Further studies are needed to improve diagnostic performance and understanding of pathophysiological mechanisms.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">20718809</PMID><DateCreated><Year>2010</Year><Month>11</Month><Day>02</Day></DateCreated><DateCompleted><Year>2011</Year><Month>02</Month><Day>11</Day></DateCompleted><DateRevised><Year>2016</Year><Month>11</Month><Day>25</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1475-097X</ISSN><JournalIssue CitedMedium="Internet"><Volume>30</Volume><Issue>6</Issue><PubDate><Year>2010</Year><Month>Nov</Month></PubDate></JournalIssue><Title>Clinical physiology and functional imaging</Title><ISOAbbreviation>Clin Physiol Funct Imaging</ISOAbbreviation></Journal><ArticleTitle>Lymphoedema of the lower extremities--background, pathophysiology and diagnostic considerations.</ArticleTitle><Pagination><MedlinePgn>389-98</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/j.1475-097X.2010.00969.x</ELocationID><Abstract><AbstractText>Lymphoedema of the lower extremities is a chronic debilitating disease that is often underdiagnosed. Early diagnosis and treatment is paramount in reducing the risk of progression and complications. Lymphoedema has traditionally been defined as interstitial oedema and protein accumulation because of a defect in the lymphatic drainage; however, some findings suggest that the interstitial protein concentration may be low in some types of lymphoedema. Primary lymphoedema is caused by an inherent defect in the lymphatic vessels or lymph nodes. Secondary lymphoedema is caused by damages to the lymphatic system most often caused by cancer or its treatment. Many of the underlying pathophysiological mechanisms have yet to be elucidated. Many methods have been developed for examination of the lymphatic system. Lymphoscintigraphy is presently the preferred diagnostic modality. Lack of consensus regarding protocol and qualitative interpretation criteria results in a too observer dependent outcome. Methods for objectifying the scintigraphy through quantification have been criticized. Depot clearance rates are an alternative method of quantification of lymphatic drainage capacity. This method however has mostly been applied on upper extremity lymphoedema. The aim of this review is to provide a literature-based overview of the aetiology and pathophysiology of lower extremity lymphoedema and to summarize the current knowledge about lymphoscintigraphy and depot clearance techniques. The abundance of factors influencing the outcome of the examination stresses the need for consensus regarding examination protocols and interpretation. Further studies are needed to improve diagnostic performance and understanding of pathophysiological mechanisms.</AbstractText><CopyrightInformation>© 2010 The Authors. Clinical Physiology and Functional Imaging © 2010 Scandinavian Society of Clinical Physiology and Nuclear Medicine.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Jensen</LastName><ForeName>Mads R</ForeName><Initials>MR</Initials><AffiliationInfo><Affiliation>Department of Clinical Physiology and Nuclear Medicine, Bispebjerg Hospital, University Hospital of Copenhagen, Copenhagen NV, Denmark. mjen0221@bbh.regionh.dk</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Simonsen</LastName><ForeName>Lene</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Karlsmark</LastName><ForeName>Tonny</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Bülow</LastName><ForeName>Jens</ForeName><Initials>J</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2010</Year><Month>08</Month><Day>16</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Clin Physiol Funct Imaging</MedlineTA><NlmUniqueID>101137604</NlmUniqueID><ISSNLinking>1475-0961</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D019275">Radiopharmaceuticals</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D006706" MajorTopicYN="N">Homeostasis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006874" MajorTopicYN="N">Hydrostatic Pressure</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D035002" MajorTopicYN="N">Lower Extremity</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008208" MajorTopicYN="N">Lymphatic System</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D061305" MajorTopicYN="Y">Lymphoscintigraphy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011237" MajorTopicYN="N">Predictive Value of Tests</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019275" MajorTopicYN="Y">Radiopharmaceuticals</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2010</Year><Month>8</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2010</Year><Month>8</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2011</Year><Month>2</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">20718809</ArticleId><ArticleId IdType="pii">CPF969</ArticleId><ArticleId IdType="doi">10.1111/j.1475-097X.2010.00969.x</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Danemark</li></country></list><tree><noCountry><name sortKey="Bulow, Jens" sort="Bulow, Jens" uniqKey="Bulow J" first="Jens" last="Bülow">Jens Bülow</name><name sortKey="Karlsmark, Tonny" sort="Karlsmark, Tonny" uniqKey="Karlsmark T" first="Tonny" last="Karlsmark">Tonny Karlsmark</name><name sortKey="Simonsen, Lene" sort="Simonsen, Lene" uniqKey="Simonsen L" first="Lene" last="Simonsen">Lene Simonsen</name></noCountry><country name="Danemark"><noRegion><name sortKey="Jensen, Mads R" sort="Jensen, Mads R" uniqKey="Jensen M" first="Mads R" last="Jensen">Mads R. 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