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Related Experiment Videos

Lymphoedema: pathophysiology and classification.

N L Browse, G Stewart

    The Journal of Cardiovascular Surgery
    |March 1, 1985
    PubMed
    Summary
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    This review explores lymphoedema physiology and aetiology, proposing a new classification for primary lymphoedema based on known causes like vessel abnormalities and fibrosis. It clarifies distinctions between primary and secondary lymphoedema for better understanding.

    Area of Science:

    • Lymphatic System Physiology
    • Pathophysiology of Oedema

    Background:

    • Lymphoedema classification has evolved since the 1930s, with early contributions focusing on congenital underdevelopment and later efforts by Kinmonth establishing primary vs. secondary categories.
    • Radiological classifications improved understanding of anatomical abnormalities in primary lymphoedema but did not elucidate aetiology.
    • Current classifications lack a pathophysiological basis, necessitating a review of lymph production and flow.

    Purpose of the Study:

    • To review current knowledge on lymph production, lymph flow, and lymphoedema aetiology.
    • To present a novel, simple classification of lymphoedema aetiology based on physiological understanding.
    • To differentiate primary lymphoedema from secondary lymphoedema based on causative factors.

    Main Methods:

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    • Review of existing literature on lymphoedema physiology, aetiology, and classification.
    • Analysis of historical contributions (e.g., Allen, Kinmonth) and their impact.
    • Development of a new etiological classification based on physiological principles.

    Main Results:

    • Primary lymphoedema is defined as lymphoedema due to intrinsic abnormalities of lymph vessels or nodes.
    • Secondary lymphoedema results from extrinsic factors affecting lymphatics/nodes (neoplasia, filariasis, surgery, etc.).
    • Three known groups of primary lymphoedema identified: large vessel abnormalities, lymphatic valvular incompetence, and lymph node fibrosis.

    Conclusions:

    • A new etiological classification for lymphoedema is proposed, integrating physiological knowledge.
    • Primary lymphoedema can stem from specific, identifiable abnormalities in the lymphatic system.
    • Further research is needed to determine the cause of primary lymphoedema in cases with reduced lymphatics.