[Fluorescence microlymphography of the medial malleolus in healthy humans and in patients with primary lymphedema]

Abstract

Fluorescence microlymphography, a virtually atraumatic procedure, makes it possible to visualize the superficial network of skin lymphatic microvessels. 0.01 ml of 25% solution of FITC-dextran 150,000 were injected into the subepidermal layer using a steel microneedle (outer diameter 0,2 mm) connected to a microsyringe. The region above the medial ankle was examined by microlymphography in 15 healthy volunteers and 24 patients with primary lymphedema. The mean maximal propagation of the fluorescent dye in the lymphatic network, measured from the original deposit, was significantly lower (p lower than 0.001) in healthy volunteers (7.8 +/- 2.6 mm) than in patients with primary lymphedema (22.1 +/- 13.1 mm). Cutaneous reflux phenomena were demonstrated in 20% of the patients. The number of visualized precollectors was lower in patients with primary lymphedema. No significant differences were found between the mean diameters of meshes and of lymphatic capillaries in healthy volunteers and patients. However, definitely enlarged lymphatic vessels were observed in two patients with congenital lymphedema.