Which of the following are causes of secondary lymphoedema? 1. Trauma 2. Deep venous thrombosis 3. Fungal infection 4. Viral infection Select the correct answer using the code given below.
1, 2 and 3
The correct answer is 1, 2 and 3. Secondary (acquired) lymphoedema follows destruction, obstruction or infiltration of previously normal lymphatics. Trauma, including surgical trauma such as axillary or inguinal block dissection and radiotherapy, divides or fibroses lymphatics and is the commonest cause in developed countries. Deep venous thrombosis and chronic venous hypertension overload the lymphatic system and, with recurrent inflammation, cause secondary lymphatic failure (phlebolymphoedema). Fungal infection, classically interdigital tinea pedis, breaches the skin barrier and provokes repeated streptococcal cellulitis and lymphangitis that obliterate dermal lymphatics.
Statement 4, viral infection, is not a recognised cause, so every option containing 4 is excluded. The commonest cause worldwide is the parasitic infection filariasis (Wuchereria bancrofti); other causes are nodal malignancy, tuberculosis and factitious lymphoedema. Primary lymphoedema is instead congenital (Milroy), praecox (Meige, at puberty) or tarda (after 35 years).
Key point: Filariasis is the leading global cause of secondary lymphoedema, and recurrent cellulitis from tinea pedis is the key preventable cause; viruses do not cause lymphoedema.
Important Questions from Lymphatic System
- An infant presented in the surgical OPD with complaints of a unilateral swelling in the neck. The swelling was soft, cystic, partially compressible and brilliantly transilluminant. The most probable diagnosis is
- The malignancy associated with Stewart-treves syndrome is
- A 52 year old female underwent MRM (Modified Radical Mastectomy). After few years, she developed lymphedema of the ipsilateral arm. Which of the following malignancy can develop in her arm?
- An infant presented in the surgical OPD with complaints of a unilateral swelling in the neck. The swelling was soft, cystic, partially compressible and brilliantly transilluminant. The most probable diagnosis is
- Which of the following statements regarding lymphoedema are correct?
1. Patients experience constant dull ache and even severe pain sometimes
2. Manual lymphatic drainage has a role
3. Primary lymphoedema is caused by congenital lymphatic dysplasia
4. Nonne Milroy's disease is a type of primary lymphoedema
Select the correct answer using the code given below:
