Lymphangitis and lymphoedema
- Lesion
Lymph vessels can become infected (red streaks up the limb) or blocked (a swollen, firm limb that does not go away).
What it is
Lymphangitis is acute inflammation of lymphatic vessels as bacteria spread from an infection, most often group A streptococci, producing painful red streaks toward the regional nodes. Lymphoedema is swelling from blocked or absent lymphatic drainage. Primary lymphoedema is congenital or developmental (for example Milroy disease or Turner syndrome); secondary lymphoedema follows obstruction by tumour, surgery or radiation (axillary dissection for breast cancer), infection (filariasis) or scarring.
Structure
- Lymphangitis: dilated lymphatics filled with neutrophils and monocytes that extend into the surrounding tissue.
- Chronic lymphoedema: dilated dermal lymphatics, interstitial fibrosis, thickened skin with hyperkeratosis and papillomatous change.
- Chylous effusions (chylothorax, chylous ascites) occur when obstructed lymphatics rupture.
Causes of lymphoedema
| Type | Examples | Notes |
|---|---|---|
| Primary (developmental) | Milroy disease, lymphoedema praecox, Turner syndrome | Absent or underdeveloped lymphatics; appears in infancy or youth |
| Secondary, infectious | Lymphatic filariasis | Endemic in parts of the tropics; elephantiasis |
| Secondary, cancer and its treatment | Axillary dissection and radiation, tumour in lymphatics | Arm lymphoedema after breast cancer; peau d'orange |
| Secondary, other | Recurrent lymphangitis, trauma, scarring | Progressive fibrosis with each infection |
Clinical notes
- Every episode of cellulitis damages lymphatics further, so prevention of infection is central in chronic lymphoedema.
- Global programmes of mass drug administration have greatly reduced filariasis in the Americas.
Test yourself
Think of the answer, then tap the question to see it.
Which organism usually causes acute lymphangitis?
Group A β-hemolytic streptococci (Streptococcus pyogenes).
What produces peau d'orange skin in breast cancer?
Obstruction of dermal lymphatics by tumour emboli, so the swollen skin dimples at the hair follicles.
Which rare malignant tumour can arise in long-standing lymphoedema?
Lymphangiosarcoma (angiosarcoma), the Stewart–Treves syndrome.
Elsewhere in DurgiPedia
Connections
Microorganisms2
Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.
Sources: Lymphedema (StatPearls (NCBI Bookshelf), 2025); Lymphatic filariasis (World Health Organization, 2025).
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Representative model, for educational purposes only.