Lymphoscintigraphic Indications in the Diagnosis, Management and Prevention of Secondary Lymphedema
As is known, secondary lymphedema is caused by damage to the lymphatic system, often following an oncological tumor removal intervention, or even by an accident, which has severed or damaged the lymphatic vessels and/or lymph nodes.
Lymphedema can also be caused by scarring of the lymphatic vessels due to repeated infections.
From the semiotic point of view, in secondary lymphedema the skin is healthy but appears swollen. Digital pressure does not leave a significant impression, as in the case of edema due to venous insufficiency. The limbs may appear swollen and considerably increased in size.
The diagnosis of lymphedema is not easy, because the disease can also be confused with other clinical manifestations (for example, venous insufficiency edema), but an experienced Lymphologist is usually able to diagnose it with good accuracy.
However, to confirm the diagnosis, it is often necessary to resort to specialist imaging tests for an anatomo-functional definition of the pathology.
In favor of lymphoscintigraphy we can mention the simplicity of the procedure, and the minimal invasiveness that makes it accessible even in pediatric age. In addition, its easy repeatability is useful for monitoring lymphedematous pathology and the therapeutic path.
Negative factors consist of the non-presence in all health facilities of a nuclear medicine service, but its execution on an outpatient basis allows the patient to go to the closest nuclear medicine center in the area. About the use of radioactive isotopes, the scientific literature is comforting in this sense since, as mentioned above, the radiation dose level places lymphoscintigraphy, even if in SPECT/CT mode, in the category of low-risk radiation investigations.
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