Primary lower extremity lymphedema: CT diagnosis

Area of Science:

• Radiology
• Medical Imaging
• Vascular Medicine

Background:

• Lymphedema is a chronic condition characterized by fluid accumulation due to lymphatic system dysfunction.
• Primary lymphedema arises from congenital abnormalities, distinct from secondary causes like obstruction.
• Accurate diagnosis is crucial for appropriate management and differentiating causes.

Purpose of the Study:

• To present the characteristic computed tomography (CT) findings in primary lymphedema of the lower extremities.
• To illustrate how CT can exclude secondary lymphedema caused by obstructing masses.
• To correlate CT observations with pedal lymphangiography results.

Main Methods:

• Retrospective analysis of computed tomography (CT) scans from two patients diagnosed with primary lymphedema.
• Detailed description of CT imaging features, including subcutaneous compartment alterations.
• Comparison of CT findings with pedal lymphangiograms for diagnostic correlation.
• Assessment of the retroperitoneum and pelvis on CT to rule out extrinsic compression.

Main Results:

• CT demonstrated a coarse, nonenhancing, reticular pattern within an enlarged subcutaneous compartment in both cases.
• The retroperitoneum and pelvis appeared normal on CT, effectively excluding secondary lymphedema due to an obstructing mass.
• CT findings were consistent with those obtained via pedal lymphangiography.

Conclusions:

• Computed tomography (CT) provides valuable insights into the characteristic imaging patterns of primary lymphedema.
• CT is a reliable method for differentiating primary lymphedema from secondary causes by assessing for obstructing masses.
• The combination of CT and lymphangiography offers comprehensive diagnostic information for lower extremity lymphedema.