[Lymphedema--anatomy, pathophysiology and diagnosis].
Lymphedema is a protein-rich edema that develops as a result of diseased or traumatized lymphatic vessels and/or lymph nodes. Four stages of the disease are recognized. In primary lymphedema, congenital obstruction of lymphatic flow presents, and this can manifest at anytime during the course of a person's lifetime. Secondary lymphedema is a sequela of a malignant tumor, inflammatory processes, injuries, surgery or irradiation. The diagnosis is established on the basis of careful history-taking, inspection, and physical examination including measurements of circumference, which are of importance in particular for follow-up purposes, and a comparison of skinfold thickness between the healthy and afflicted sides. The use of diagnostic equipment is rarely required, with indirect lymphography and lymphoscintigraphy heading the list of options.