Navigate Up

Cancer Center - A-Z Index

#
Q
Y

Print This Page

Lymphatic obstruction

Lymphatic obstruction is a blockage of the lymph vessels that drain fluid from tissues throughout the body and allow immune cells to travel where they are needed. Lymphatic obstruction may cause lymphedema, which means swelling due to a blockage of the lymph passages.

Alternative Names

Lymphedema

Causes, incidence, and risk factors

The most common reason for lymphatic obstruction is the removal or enlargement of the lymph nodes.

Causes of lymphatic obstruction include:

In Western societies, one of the most common causes of lymphedema is removal of the breast (mastectomy ) and underarm lymph tissue for breast cancer. This causes lymphedema of the arm in 10 - 15% of patients, because the lymphatic drainage of the arm passes through the armpit (axilla).

Rare forms of lymphedema that are present from birth (congenital) may result from problems in the development of the lymphatic vessels.

Symptoms

The main symptom is persistent (chronic) swelling, usually of the arm or leg.

Signs and tests

The doctor will perform a physical exam and ask questions about your medical history.

The following tests may be done:

Treatment

Treatment for lymphedema includes:

  • Compression (usually with multilayered bandages)
  • Manual lymph drainage (MLD)
  • Range of motion exercises

Manual lymph drainage is a light massage therapy technique in which the skin is moved in certain directions based on the structure of the lymphatic system. This helps the lymph fluid drain through the proper channels.

Treatment also includes skin care to prevent injuries, infection, and skin breakdown, as well as light exercise and movement programs. Exercise should be carefully designed by your doctor and a physical therapist. It should help drainage without leading to swelling, which could make your condition worse.

Wearing compression stockings on the affected area or using a pneumatic compression pump on and off may be helpful. Your doctor and physical therapist will decide which compression methods are best.

Surgery is used in some cases, but it has limited success. The surgeon must have a lot of experience with this type of procedure. You will still need physical therapy after surgery to reduce lymphedema.

Types of surgery include:

  • Removal of abnormal lymphatic tissue
  • Transplant of normal lymphatic tissues to areas with abnormal lymphatic drainage (less common)

Rarely, the surgeon will bypass abnormal lymph tissue using vein grafts. These procedures are not usually successful and are often done experimentally.

Expectations (prognosis)

Lymphedema is a chronic disease that usually requires lifelong management. In some cases, lymphedema improves with time. However, some swelling is usually permanent.

Complications

In addition to swelling, the most common complications include:

  • Chronic wounds and ulcers
  • Skin breakdown

You must be vigilant about skin care and hygiene. There is also a small risk of developing a lymph-tissue type of cancer.

Calling your health care provider

See your doctor if you have swelling of your arms, legs, or lymph nodes that does not go away.

Prevention

Most surgeons now use a technique called sentinel lymph node sampling to reduce your risk of lymphedema after breast cancer surgery. However, this technique is not always appropriate or effective.

References

Kerchner K, Fleischer A, Yosipovitch G. Lower extremity lymphedema update: pathophysiology, diagnosis, and treatment guidelines. J Am Acad Dermatol. 2008;59:324-331.

Davidson N. Breast cancer and benign breast disorders. InGoldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 204.

Diemert DJ. Tissue nematode infections. In Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 366.

Updated: 9/3/2012

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com