Examination of the lymphatic system
Many diseases of the lymphatic system can be diagnosed by a detailed examination of the patient without further aids. In the case of lymphangitis, in addition to the nearest lymph nodes, which are often painfully swollen as part of the inflammation, the starting point for the infection is always sought. As lymphatic inflammation spreads from the portal of entry to the center of the body, the focus of inflammation can usually be seen at the onset of redness - a skin injury, syringe canal, inflamed infusion needle, or insect bite are common causes of superficial lymphangitis.
Lymphedema can also be detected with a trained eye. When palpating the affected body region, the doughy consistency of the tissue is noticeable and, even under light pressure, palpable dents remain in the tissue for a long time. Lymphedema on the legs typically shows pronounced wrinkles above the toes and the skin on the toes can not be lifted off the subcutis (Stemmer sign). Also, the toes are swollen - unlike an edema, which is caused by a venous drainage disorder.
With lymphography and lymphoscintigraphy, two methods are available to more accurately represent lymphatic drainage in the body. In lymphography, a contrast agent is injected into or around the lymphatic vessels of the region to be examined and in the X-ray image then the drainage and lymph nodes dar. Especially in drainage disorders can be located so exactly where the lymph drainage is obstructed - be it by too few lymph channels or because the outflow is located in the area of a lymph node collection.
Lymph nodes: examination of cancers
The involvement of lymph nodes plays a major role especially in malignant diseases. In order to determine the extent to which tumor cells have already spread to the lymph nodes via the lymphatics, a lymphoscintigraphy is often performed before surgery.
In the process, some radioactive substance is injected near the tumor and the removal via the lymph is monitored. In the nearby lymph nodes, the substance accumulates, the surgeon can remove these lymph nodes during surgery and examined for tumor cells. If the nearby lymph nodes are free of cancerous cells, we now know that you do not have to remove the other lymph nodes (sentinel node method).
Treatment of diseases of the lymphatic system
While lymphangitis can be controlled by appropriate hygiene measures, disinfection and medical support with antibiotics and antipyretics, lymphedema is treated with massages (manual lymphatic drainage), physiotherapy and special compression stockings or gloves. Overweight should be reduced and endurance sports such as cycling or hiking stimulate the metabolism and support the venous return. Unfortunately, a primary lymphoedema will usually not disappear with the use of all treatment options, but the consequences will be reduced.
Secondary lymphedema: treating causes
In the past, secondary lymphoedema often occurred after cancer surgery because all lymph nodes in the tumor area were removed or the small lymphatic vessels were damaged by radiation treatment. In addition to the above-mentioned treatment methods, the causative disease is also combatted - be it through medication as in inflammatory processes or through the treatment of cancer.
A postoperative lymph fistula is treated with a sterile pressure bandage. If the injured lymphoid tracts do not close after several days, the membranes will be glued to tissue adhesive in a new operation. Inflammatory lymph node swelling develops after treatment of the underlying disease. Lymph node swelling, which is due to leukemia or Hodgkin's disease, must be fully treated chemo- and radiotherapeutic.
Prevention of diseases of the lymphatic system
The lymph node examination plays an important role in breast cancer prevention, as a monthly scan of the breast should always include a scan of the axillary lymph nodes. Lymphatic drainage also plays a role in the development of cellulite. Regular plucking massages and a bit of sport stimulate the outflow of metabolic products - and unsightly dents on the thighs are soon no longer an issue!