Primary and Secondary Lymphedema
There are two types of lymphedema - primary lymphedema and secondary lymphedema. Both types relate to lymph vessels or lymph nodes that are missing, damaged, removed or otherwise impaired.
The lymphatic system may be abnormal from birth. When a lymphatic system is no longer able to cope with the demands placed on it, primary lymphedema can develop. It is called 'primary' as the cause of the impairment is to be found in the structure of the lymphatic system itself. Primary lymphedema can be classified to age of onset.
Congenital: The lymphedema is noticeable at birth
Praecox: Lymphedema occurs after birth, but before age 35
Tardum: Lymphedema presents after age 35
Primary lymphedema can present as a variety of abnormalities:
- Aplasia: Portions of the lymph systems are missing.
- Hypoplasia: Lymph collectors are smaller in size, or the number of collectors is below normal levels. This is the most common abnormality seen in primary lymphedema.
- Hyperplasia: Lymph collectors are larger than normal, but don't always function as well as normal lymphatics.
Secondary lymphedema is caused when an outside factor directly impacts the lymph system. The lymphatic system is fully adequate and functions perfectly until it is damaged. Causes of secondary lymphedema include:
- Cancer surgery/radiation: Removal of lymph nodes that is often associated with cancer can disrupt lymph flow. Radiation treatment can also impair lymph flow.
- Malignant tumors: The tumors put pressure on lymph vessels, decreasing fluid flow.
- Trauma: The body sustains an injury, including burns or a crushing injury, which can inhibit the flow of lymph fluid.
- Infection: Recurrent infections can cause failure of lymphatic vessels.
- Chronic Venous Insufficiency: This venous disorder puts extra pressure on your lymphatic system, leading to a breakdown.
- Obesity: The increased lymphatic flow, and often time-increased pressure on lymph nodes, can impair lymphatic flow.
- Self-Induced: A patient uses a tourniquet to impair lymphatic and venous flow.
- Iatrogenic: This is lymphedema caused by a health care related procedure, such as an interventional procedure or tourniquet.
- Filariasis: A parasitic disease found mostly in third-world countries that impairs the lymphatic system.