Friday, February 24, 2012

Computerized tomography of 150 cases of lymphedema of the leg

This is a very old abstract from 1998. What was fascinating to me personally, is the CT description of the leg tissue with lymphedema. It reminded me of the ones I have had on both legs.

In the early 1970's, I had three Thompsons procedures done on my left leg, and none done on the right. There is a noticeable difference internally for the legs. Strange too was the fact that after a week in the hospital last year, it was the left leg that experienced the greatest decrease in swelling - specifically due to the fact that according to the CT, it has a much smaller amount of subcutaneous tissue then the left.

Does that make the surgery worthwhile? Hardly, the complications, including lymphoma still make it a terrible choice for lymphedema treatment. It is also the only leg that has experienced cellulitis.

The abstract follows:

Computerized tomography of 150 cases of lymphedema of the leg

Nov 1998

[Article in French]


Hôpital Saint-Michel, Paris, France.


The aim of this work was to evaluate the usefulness of CT imaging to stage lower limb lymphedemas. Between 1992 and 1997, we studied 150 cases of lymphedema, half idiopathic and half secondary. Methods used are described. In decreasing order of frequency, we found: skin thickening, increased subcutaneous tissue surface area compared with the healthy limb, thickening of the perimuscular aponevrosis, fat infiltration: lines parallel to the skin (parallel), edematous areas along the perimuscular aponevrosis, lines perpendicular to the skin (perpendicular). The lowest fat density was increased on the diseased side. The subfascial tissue showed some fat accumulation. These results were compared with findings reported in the literature. There were very major differences between idiopathic lymphedema and secondary lymphedema of the thigh. Similar images were generally generated by new and long-standing lymphedema. Rarely useful for positive diagnosis, CT is indispensable for establishing stage initially or after recent increase and, in our opinion, is essential for pretherapeutic assessment. The CT-scan gives objective evidence of overall disorders, the exact upper limit of the lymphedema, and sometimes reveals infraclinical bilateral involvement.

Full text arricle: EM/Consulte

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