1/452. lymphangiosarcoma in chronic lymphoedema. Stewart-Treves syndrome.A case of post-mastectomy lymphangiosarcoma is reported. lymphangiosarcoma is an extremely rare but highly lethal complication of chronic lymphoedema. Our patient was treated by amputation and died 6 months later. Treatment of post-mastectomy lymphangiosarcoma is still unsatisfactory. Early recognition and radical ablative surgery seem to provide best chance for survival.- - - - - - - - - - ranking = 1keywords = edema (Clic here for more details about this article) |
2/452. Lymphoedema and hand surgery.We report the case of a woman with a previous history of breast carcinoma, treated with a left radical mastectomy and axillary clearance, who developed lymphoedema in the left arm following a carpal tunnel decompression complicated by a superficial wound infection.- - - - - - - - - - ranking = 1keywords = edema (Clic here for more details about this article) |
3/452. Lymphoedema, lymphatic microangiopathy and increased lymphatic and interstitial pressure in a patient with Parkinson's disease.New microvascular findings in a woman with Parkinson's disease and lower leg oedema are presented. Microlymphography showed enhanced filling of the microlymphatic network with the fluorescent contrast medium comparable to the findings in lymphoedema. The microlymphatic and interstitial pressures of the skin were increased (27 mm Hg and 16 mm Hg respectively). The increased interstitial and microlymphatic pressures are the result of insufficient venous and lymphatic drainage due to impairment of calf muscle function during walking in Parkinson's disease. Manual lymph drainage and compression therapy, in combination with improvement of calf muscle function, resulted in regression of the oedema.- - - - - - - - - - ranking = 1.4keywords = edema (Clic here for more details about this article) |
4/452. Duplication within chromosome 5q characterized by fluorescence in situ hybridization.We present a 16-month-old boy with developmental delay, minor anomalies, small penis, and lymphedema of the upper limbs. Routine cytogenetic analysis suspected a duplication of 5q. Fluorescent in situ hybridization (FISH) with a cosmid probe (MCC at the 5q22 APC region) showed tandemly duplicated fluorescent signals on one of chromosomes 5, whereas FISH with three YAC probes (TYAC12 at 5q35, HTY3182 at 5q34, and TYAC139 at 5q31) did not give duplicated signals. These findings indicate a duplication of 5q22 band in one chromosome 5. The boy we describe here is the first case of a pure partial duplication of 5q to be proven by FISH techniques. A review of previously reported cases of putative partial 5q duplication showed no consistent phenotype.- - - - - - - - - - ranking = 0.2keywords = edema (Clic here for more details about this article) |
5/452. Upper respiratory problems in the yellow nail syndrome.A case of the yellow nail syndrome is described. The characteristic nail changes were associated with pleural effusions, lymphoedema of the face and legs and upper respiratory symptoms. The finding of extremely hard ear wax has not been reported previously. A satisfactory response to combination diuretic therapy was seen. The case of recognition of the Syndrome is emphasized together with the danger of excessive investigation if the nails are not inspected. Possible mechanisms for the formation of extremely hard cerumen are discussed.- - - - - - - - - - ranking = 0.2keywords = edema (Clic here for more details about this article) |
6/452. Spontaneous chylothorax associated with primary lymphedema and a lymphangioma malformation.Spontaneous chylothorax associated with primary lymphedema is an exceedingly rare clinical entity. We report a case of chylothorax in a 38-year-old woman with a history of primary lymphedema of the right leg and an inguinal lymphangioma. Pathophysiology, diagnosis, treatment, as well as literature review are presented.- - - - - - - - - - ranking = 1.2keywords = edema (Clic here for more details about this article) |
7/452. Autonomic regulation of lymphatic flow in the lower extremity demonstrated on lymphoscintigraphy in patients with reflex sympathetic dystrophy.PURPOSE: nuclear medicine techniques were used to show that the peripheral lymphatics are under autonomic control in much the same way as the blood vessels that supply the same anatomic region. methods: Three patients with complex regional pain syndrome type 1 (reflex sympathetic dystrophy) involving a lower extremity were evaluated using three-phase bone scintigraphy and peripheral lymphoscintigraphy. Each patient was treated with ipsilateral chemical lumbar sympathectomy, and lymphoscintigraphy was repeated within several days of the procedure. RESULTS: All three patients had evidence of decreased flow (compared with the contralateral extremity) to normal flow after ipsilateral sympathectomy. Bone scintigraphy, before and after sympathectomy, was difficult to interpret because of the effects of altered weight bearing. Two patients who had unilateral peripheral edema showed marked improvement after sympathectomy and increased lymphatic flow. CONCLUSIONS: Peripheral lymphatic function is controlled by the autonomic nervous system. In reflex sympathetic dystrophy, peripheral edema may be caused by an increased sympathetic stimulus to the lymphatics. Further study of this phenomenon may show that nuclear medicine studies, such as bone scintigraphy and lymphoscintigraphy, can be used to distinguish patients who will benefit from sympathectomy from those who will not, thereby obviating invasive testing and unnecessary invasive treatment.- - - - - - - - - - ranking = 0.4keywords = edema (Clic here for more details about this article) |
8/452. Juvenile rheumatoid arthritis and lymphoedema: lymphangiographic aspects.We report a 5 1/2-year-old boy with juvenile rheumatoid arthritis (JRA) and lower-limb lymphoedema. US, MRI and lymphangiography were performed. Based on the lymphangiographic study, we propose a pathogenesis based on obstruction of normal superficial lymphatic vessels in the affected limb. This is discussed with other pathogenetic factors proposed in the 16 previously reported cases of lymphoedema complicating JRA.- - - - - - - - - - ranking = 1.2keywords = edema (Clic here for more details about this article) |
9/452. Bilateral groin adenolymphoceles: an unusual presentation of chylous reflux.We report an unusual presentation of a young man with bilateral groin lymph nodal adenolymphoceles and right leg lymphedema as a manifestation of intestinal lymphangiectasia. Chylous reflux was supported by conventional and isotopic lymphography as well as by a total lipid test showing delayed triglyceride absorption 24 hours after ingestion of 60 gm of butter. After excision of groin masses in conjunction with dietary control (short-medium chain triglycerides), manual massage, pneumatic compression, and long-term wearing of a low stretch elastic garments he remains well.- - - - - - - - - - ranking = 0.2keywords = edema (Clic here for more details about this article) |
10/452. Treatment of may-thurner syndrome with catheter-directed thrombolysis and stent placement, complicated by heparin-induced thrombocytopenia.may-thurner syndrome is an uncommon process in which the right common iliac artery compresses the left common iliac vein, resulting in left iliofemoral deep vein thrombosis and severe leg edema. We report the case of a 41-year-old female who presented with severe left leg edema present for 1 day. One week earlier she had experienced acute shortness of breath and pleuritic chest pain. Duplex ultrasound revealed a left iliofemoral deep vein thrombosis. A computed tomography (CT) scan performed for abdominal pain revealed thrombosis of the entire left common and external iliac veins. A ventilation-perfusion scan diagnosed a pulmonary embolism. The patient was treated with systemic intravenous heparin and catheter-directed thrombolysis of the iliofemoral deep vein thrombosis. Complete thrombolysis and iliofemoral vein patency was achieved over 5 days. A persistent stenosis in the left common iliac vein consistent with may-thurner syndrome was alleviated with percutaneous balloon angioplasty and placement of a Wallstent. heparin therapy was terminated at the time of stenting because of suspected heparin-induced thrombocytopenia. The patient was started on a continuous infusion of 10% dextran 40, and warfarin therapy was initiated. heparin-induced antibodies were confirmed by a C-14 serotonin release assay. The endovascular reconstruction remains patent 4 months later. heparin-induced thrombocytopenia complicating endovascular reconstruction of the iliofemoral venous system in a patient with may-thurner syndrome is an uncommon occurrence. This case and a review of the literature are discussed.- - - - - - - - - - ranking = 0.4keywords = edema (Clic here for more details about this article) |
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