ABSTRACT
Lymphedema is a progressive condition of chronic degenerative and inflammatory processes not only involving the lymphatic system but also the entire skin and soft tissue together resulting in fibrotic changes following recurrent episodes of dermato-lympho-adenitis. Such a steadily progressing condition throughout the entire surrounding soft tissue will eventually result in a disabling and distressing condition often associated with many potentially serious complications. Accurate staging is, therefore, mandated as a reliable and objective method of assessing the patient status to guide proper management. Thus far, none of the current staging systems, mostly based on the clinical findings alone, are able to provide sufficient guidelines for improved management of lymphedema in different stages. Laboratory staging based on the functional study of the lymphatic system with radionuclide lymphoscintigraphy is able to provide a much more accurate assessment of the condition of chronic lymphedema as a precise method of evaluation of lymphatic function. A new approach based on a combined clinical and laboratory staging system may allow earlier determination of treatment failure and add a timely supplemental treatment to failed decongestive lymphatic therapy. Additionally, this will enable optimal timing of potential surgical therapies.
