[Clinical aspects of lymphedema and contrast medium lymphography]

Primary lymphedema of the lower extremities is a clinical entity often misdiagnosed, especially in its mild, distal forms. Its characteristics are: swelling, tightness of the skin, and deepening of the skin folds of one foot, mainly in young girls. Proximal forms with involvement of the lower leg and thigh are often congenital. In later years, these manifestations have to be distinguished from secondary lymphedema due to a block in the lymph nodes (e.g. in malignoma), starting with swelling of the proximal regions of the extremities and the genitalia. Indirect lymphography, especially with new contrast media, however, offer new diagnostic possibilities. The best routine method to confirm or exclude lymphedema is isotopic lymphography.