ALTHOUGH lymphedema is not acommon cause of swelling of the extremities neither is it rare, and occasionally the family physician is consulted by an anxious adolescent girl who complains of progressive swelling of the legs. Too often the physician knows little or nothing about the condition and is inclined merely to sympathize with the patient whose symptoms indicate eventual “piano legs” or elephantiasis. It is true that once the end stage of intractable, fibrous edema is reached, treatment is generally unsatisfactory; however, initiated early in the disease it is usually successful, and will in most cases, keep the edema under control and avoid the adverse psychologic patterns often encountered in a woman with unsightly legs.
General unawareness of the entity of lymphedema stems from the fact that little has been written on the subject and consequently it is passed over lightly in medical schools and textbooks. In recent years the excellent works of Drinker and Field1 on the anatomy and physiology of the lymphatic system, and Allen2 on the classification, etiology and differential diagnosis based on 300 cases at the Mayo Clinic, have done much to clarify and simplify the previous confusion concerning lymphedema.
Definition. Lymphedema is an abnormal accumulation of lymph in the soft tissues. It is characterized by swelling, usually of the extremities, in the early stages, and by so-called elephantiasis, the result of continued edema and fibrosis, in the late stages. It is generally conceded that the term elephantiasis should not be used synonymously with lymphedema since. . .