Background: The incidence of primary and secondary lymphedema, factors influencing secondary lymphedema and concomitance with venous insufficiency were retrospectively evaluated in patient with pain and swelling in the legs.

Methods: A total of 224 patients (136 males, 88 females; mean age 24±6.2 years; range 20 to 51 years) with a ≥5 cm circumference difference in the lower limb were included the study. Grade of lymphedema, skin color changes, history of lympadenectomy and/or radiotherapy due to infection, trauma or malignancy and the starting time of their complaints were evaluated.

Results: Among all the patients, 9.8% had bilateral, and 90.2% had unilateral lymphedema. Among patients with bilateral lymphedema, 8 were of primary, and 9 of secondary type, 3 cases were idiopathic and 2 patients had Klippel- Trenaunay syndrome. In unilateral lymphedema, 14% were primary, 72% were secondary, 3.6% were idiopathic, 7.2% were mixed type and 3.2% had Klippel-Trenaunay syndrome. Univariate analysis revealed that cellulites, lymphangitis, previous surgical intervention, trauma and lympadenectomy and/or radiotherapy of the inguinal region for malignancy were significant factors for secondary lymphedema. Multivariate analysis demonstrated that cellulites, lymphangitis and lympadenectomy and/or radiotherapy of the inguinal region for malignancy were significant factors.

Conclusion: Recurrent infections can cause permanent lymphedema particularly in susceptible patients. Moreover, lympadenectomy for neoplasms with lymph node metastasis and radiotherapy of the inguinal region are also causes of permanent lymphedema.

Keywords : Diagnostic imaging; lymphedema/diagnosis