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Combined Clinical and Laboratory (Lymphoscintigraphic) Staging

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Lymphedema

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Abstract

Accurate staging of patients with chronic lymphedema is essential to provide a reliable and objective method of classifying patients to guide proper treatment and management. The current staging system proposed by the International Society of Lymphology (ISL) considers only physical exam features with no consideration of clinical, quality of life, or radiographic features. Herein we describe new classification system combining clinical and radiographic data. We present our initial data and management strategies utilizing this new classification system.

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Highlighted References

  1. Lee BB, Bergan JJ. New clinical and laboratory staging systems to improve management of chronic lymphedema. Lymphology. 2005;38(3):122–9.

    CAS  PubMed  Google Scholar 

  2. Lee BB. Classification and staging of lymphedema. In: Tredbar LL, Morgan CL, Lee BB, Simonian SJ, Blondeau B, editors. Lymphedema-diagnosis and treatment. London: Springer; 2008. p. 21–30. Chap. 3.

    Google Scholar 

  3. Karacavus S, Yilmaz YK, Ekim H. Clinical significance of lymphoscintigraphy findings in the evaluation of lower extremity lymphedema. Mol Imaging Radionucl Ther. 2015;24(2):80–4.

    Article  PubMed  PubMed Central  Google Scholar 

  4. International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema. 2013 consensus document of the International Society of Lymphology. Lymphology. 2013;46:1–11.

    Google Scholar 

  5. de Godoy JMP, Braile DM, de Godoy MF, et al. Quality of life and peripheral lymphedema. Lymphology. 2002;35:72.

    Google Scholar 

References

  1. Hwang JH, Lee KW, Chang DY, et al. Complex physical therapy for lymphedema. J Korean Acad Rehabil Med. 1998a;22(1):224–9.

    Google Scholar 

  2. Szolnoky G, Lakatos B, Keskeny T, Dobozy A. Advantage of combined decongestive lymphatic therapy over manual lymph drainage: a pilot study. Lymphology. 2002;35(Suppl):277–82.

    Google Scholar 

  3. Lee BB, Kim DI, Whang JH, Lee KW. Contemporary management of chronic lymphedema – personal experiences. Lymphology. 2002;35(Suppl):450–5.

    Google Scholar 

  4. Lee BB. Current issue in management of chronic lymphedema: personal reflection on an experience with 1065 patients. Commentary. Lymphology. 2005;38:28.

    CAS  PubMed  Google Scholar 

  5. Olszewski WL. Episodic dermatolymphangioadenitis (DLA) in patients with lymphedema of the lower extremities before and after administration of benzathine penicillin: a preliminary study. Lymphology. 1996;29:126–31.

    CAS  PubMed  Google Scholar 

  6. Azevedo WF, Boccardo F, Zilli A, et al. A reliable and valid quality of life in patients with lymphedema – version of the SF-36. Lymphology. 2002;35(suppl):177–80.

    Google Scholar 

  7. Launois R, Mègnigbêto AC, Pocquet K, Alliot F. A specific quality of life scale in upper limb lymphedema: the ULL-27 questionnaire. Lymphology. 2002;35(suppl):181–7.

    Google Scholar 

  8. Case TC, Witte CL, Witte MH, et al. Magnetic resonance imaging in human lymphedema: comparison with lymphangioscintigraphy. Magn Reson Imaging. 1992;10:549–58.

    Article  CAS  PubMed  Google Scholar 

  9. Yeo UC, Lee ES, Lee BB. Ultrasonographic evaluation of the lymphedema. Ann Dermatol. 1997;9(2):126–31.

    Article  Google Scholar 

  10. Ketterings C, Zeddeman S. Use of the C-scan in evaluation of peripheral lymphedema. Lymphology. 1997;30:49–62.

    CAS  PubMed  Google Scholar 

  11. Szuba A, Shin WS, Strauss HW, Rockson S. The third circulation: radionuclide lymphoscintigraphy. J Nucl Med. 2003;44(1):43–57.

    PubMed  Google Scholar 

  12. Kalawat TC, Chittoria RK, Reddy PK, et al. Role of lymphoscintigraphy in diagnosis and management of patients with leg swelling of unclear etiology. Indian J Nucl Med. 2012;27(4):226–30.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Mihara M, Hara H, Narushima M, et al. Indocyanine green lymphography is superior to lymphoscintigraphy in imaging diagnosis of secondary lymphedema of the lower limbs. J Vasc Surg Venous and Lym Dis. 2013;1:194–201.

    Google Scholar 

  14. Unno N, Nishiuama M, Suzuki M, et al. A novel method of measuring human lymphatic pomping using indocyanine green fluorescence lymphography. J Vasc Surg. 2010;52:946–52.

    Article  PubMed  Google Scholar 

  15. International Society of Lymphology Executive Committee. The diagnosis and treatment of peripheral lymphedema. Lymphology. 1995;28:113–7.

    Google Scholar 

  16. Lee BB, Villavicencio JL. Primary lymphedema and lymphatic malformation: are they the two sides of the same coin? Eur J Vasc Endovasc Surg. 2010;39:646–53.

    Article  CAS  PubMed  Google Scholar 

  17. Lee BB. Chronic lymphedema, no more stepchild to modern medicine! Eur J Lymphology. 2004;14(42):6–12. In the evaluation of lymphedema. J Nucl Med. 2003;44(1):43–57.

    Google Scholar 

  18. Yamamoto T, Matsuda N, Todokoro T, et al. Lower extremity lymphedema index. Ann Plast Surg. 2011;67:637–40.

    Article  CAS  PubMed  Google Scholar 

  19. Yamamoto T, Tamamoto N, Jayashi N, et al. Practicality of the lower extremity lymphedema index. Ann Plast Surg. 2016;77:115–8.

    Article  CAS  PubMed  Google Scholar 

  20. Nieto S. Stages of lymphedema according to correlation among pathophysiology, clinical features, imaging and morphology of the affected limbs. Lymphology. 2002;35(suppl):163–7.

    Google Scholar 

  21. Bruna J, Miller AJ, Beninson J. The clinical grading and simple classification of lymphedema. Lymphology. 2002;35(suppl):160–2.

    Google Scholar 

  22. Johansson K, Ohlsson K, Ingvar C, et al. Factors associate with the development of arm lymphedema following breast cancer treatment: a match pair case-control study. Lymphology. 2002;35:59.

    CAS  PubMed  Google Scholar 

  23. Foldi E. Prevention of dermatolymphangioadenitis by combined physiotherapy of the swollenarm after treatment for breast cancer. Lymphology. 1996;29:48–9.

    CAS  PubMed  Google Scholar 

  24. Hwang JH, Lee KW, Lee BB. Improvement of lymphatic function after complex physical therapy. J Korean Acad Rehabil Med. 1998b;22(3):698–704.

    Google Scholar 

  25. Choi JY, Hwang JH, Park JM, et al. Risk assessment of dermatolymphangioadenitis by lymphoscintigraphyin patients with lower extremity lymphedema. Korean J Nucl Med. 1999;33(2):143–51.

    Google Scholar 

  26. Hwang JH, Kwon JY, Lee KW, et al. Changes in lymphatic function after complex physical therapy for lymphedema. Lymphology. 1999;32:15–21.

    CAS  PubMed  Google Scholar 

  27. Lee BB, Kim YW, Kim DI, Hwang JH, Laredo J, Neville R. Supplemental surgical treatment to end stage (stage IV–V) of chronic lymphedema. Int Angiol. 2008;27(5):389–95.

    CAS  PubMed  Google Scholar 

  28. Kim DI, Huh S, Lee SJ, Hwang JH, Kim YI, Lee BB. Excision of subcutaneous tissue and deep muscle fascia for advanced lymphedema. Lymphology. 1998;31:190–4.

    CAS  PubMed  Google Scholar 

  29. Huh SH, Kim DI, Hwang JH, Lee BB. Excisional surgery in chronic advanced lymphedema. Surg Today. 2003;34:434–5.

    Google Scholar 

  30. Lee BB. Surgical management of lymphedema. In: Tredbar LL, Morgan CL, Lee BB, Simonian SJ, Blondeau B, editors. Lymphedema: diagnosis and treatment. London: Springer; 2008. p. 55–63. Chap. 6.

    Chapter  Google Scholar 

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Author information

Authors and Affiliations

  1. George Washington University, Washington, DC, USA

    Kendal Endicott

  2. Center for the Lymphedema and Vascular Malformations, Division of Vascular Surgery, Department of Surgery, George Washington University, Washington, DC, USA

    James Laredo

  3. Center for the Lymphedema and Vascular Malformations, Division of Vascular Surgery, Department of Surgery, George Washington University, Washington, DC, USA

    Byung-Boong Lee

  4. Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Byung-Boong Lee

Authors
  1. Kendal Endicott
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  2. James Laredo
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  3. Byung-Boong Lee
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Corresponding author

Correspondence to Kendal Endicott .

Editor information

Editors and Affiliations

  1. Center for the Lymphedema and Vascular Malformations, Division of Vascular Surgery, Department of Surgery, George Washington University, Washington, DC, USA

    Byung-Boong Lee

  2. Falk Cardiovascular Research Center, Stanford University School of Medicine, Stanford, California, USA

    Stanley G. Rockson

  3. La Jolla, California, USA

    John Bergan

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Endicott, K., Laredo, J., Lee, BB. (2018). Combined Clinical and Laboratory (Lymphoscintigraphic) Staging. In: Lee, BB., Rockson, S., Bergan, J. (eds) Lymphedema. Springer, Cham. https://doi.org/10.1007/978-3-319-52423-8_15

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  • DOI: https://doi.org/10.1007/978-3-319-52423-8_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-52421-4

  • Online ISBN: 978-3-319-52423-8

  • eBook Packages: MedicineMedicine (R0)

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