Vascular Diseases
Lymphatic Diseases
Written byTriantafyllos Giannakopoulos MD, PhD, FEBVS, FACSMedically reviewed: 27 July 2026
Understanding and Treating Lymphatic System Disorders
The Basics
The Lymphatic System
Lymphatic Vessels
Lymphatic vessels also belong to the Circulatory system and are responsible for returning Lymph back to the circulation. Lymph consists of the fluid that escapes from blood vessels and accumulates between cells, as well as all external agents (microorganisms and toxic substances) that enter the interstitial space due to injury or other pathological conditions.
The direction of flow is the same as that of veins (from the periphery and extremities toward the heart) but the velocity of fluid movement in the lymphatic vessels is much slower. The force that propels the fluid within the lymphatic vessels is a combination of small peristaltic movements of the lymphatic walls and the capillary effect.
Lymph Nodes: Defense Stations
During its journey, Lymph passes through intermediate stations called Lymph Nodes, where the immune system identifies harmful external agents and initiates the body's defense process.
Groups of Lymph Nodes are found in the Inguinal and Axillary regions, in the neck (Cervical area), and within the Thoracic and Abdominal cavities. As they approach the heart, the lymphatic vessels merge (converge), becoming progressively larger in diameter and ultimately drain into the venous system at a point called the Venous Angle, located in the left Subclavian vein.
Illustration of the lymphatic system
Diseases
Lymphatic Disorders
Lymphangitis — inflammation of lymphatic vessels
Lymphangitis — Cellulitis
Infection of the lymphatic vessels (invasion by a microbial agent) causes inflammation called Lymphangitis. This is characteristically accompanied by red streaks with tenderness and fever.
Quite often, lymphangitis is caused by or coexists with Cellulitis, which is a more generalized infection of the subcutaneous tissue (the tissue between the skin and muscles). This causes diffuse redness and warmth of the affected area, fever (or low-grade fever), and the red lines of lymphangitis may not be visible.
Characteristics of Lymphangitis — Cellulitis
Immediate Management
The management of Lymphangitis — Cellulitis requires immediate assessment by a specialist with timely antibiotic therapy to avoid irreversible complications such as lymphedema.
By a Specialist
Immediate assessment by a Vascular Surgeon or specialist physician.
Immediate Evaluation
Timely diagnosis and assessment of the extent of the infection.
Antibiotic Therapy
Timely administration of appropriate antibiotic therapy.
Complication Prevention
Prevention of lymphedema and other irreversible complications.
Lymphedema
What is Lymphedema?
Lymphedema is the accumulation of interstitial fluid in one or more parts of the body and may be due to either congenital agenesis (absence) of lymphatic vessels (Primary Lymphedema), or dysfunction of lymphatic vessels caused by an acquired factor (Secondary Lymphedema).
Primary Lymphedema
Congenital agenesis (absence) of lymphatic vessels — a pathological condition from birth.
Secondary Lymphedema
Dysfunction from an acquired factor — injury, infection, tumor or surgical procedure.
Most Common Causes of Secondary Lymphedema
Chronic retention of lymph in the tissues gradually leads to hardening, skin thickening and worsening of the edema if left untreated.
Characteristics of Lymphedema
Comparison of normal and edematous leg
Treatment
Therapeutic Approach
Management of Lymphedema
The success of lymphedema treatment depends on the stage the patient is at and must be evaluated by their Vascular Surgeon.
Decongestive Manual Massage
The main pillar of therapy. Sessions of decongestive manual massage (also known as lymphatic massage) by specially trained physiotherapists.
Special Garment
Special graduated compression garment for lymphedema (stocking or glove). Its role is to maintain the result of the manual massage for as long as possible.
Special Devices
Special devices that perform lymphatic massage and whose results can be compared to manual massage.
Surgical Techniques
Lymphatic-venous anastomoses and lymph node auto-transplantation — causal treatment of lymphedema.
Note: Lymphedema treatment requires an individualized approach and collaboration between patient and treating physician for the best possible results.
Contact Us
Do you need specialized evaluation for lymphatic diseases? Contact us for a detailed assessment and personalized therapeutic approach.
References
- International Society of Lymphology Executive Committee The Diagnosis and Treatment of Peripheral Lymphedema: 2023 Consensus Document of the International Society of Lymphology. Lymphology 56(4):133–151 (2023) — doi.org/10.2458/lymph.6372
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