Lymphatic research and biology最新文献

{"title":"Exploring Lower Limb Volume Estimation: Application and Evaluation of Limb Volume Equations with Ideal Circumferential Measurement Intervals.","authors":"Wen-Han Huang, Min-Lan Lin, Tong-Yu Liu","doi":"10.1177/15578585261473404","DOIUrl":"https://doi.org/10.1177/15578585261473404","url":null,"abstract":"<p><strong>Background: </strong>Accurate limb volume measurement is essential for the early detection and continuous monitoring of lower limb lymphedema. We aim to validate the applicability of existing upper limb volume formulas for lower limb volume measurement and to determine the optimal interval for such measurements.</p><p><strong>Methods and results: </strong>Eighty-seven patients who underwent whole lower limb computed tomography (CT) scans due to lower limb edema were enrolled. The volume of the lower limbs was examined using the CT method and the formula method. The measurement range extended from a horizontal line 8 cm below the inferior border of the pubic symphysis to a line 5 cm above the medial malleolus. Differences and consistency between the two methods were compared to identify the optimal measurement interval. There were statistical differences between the formula and CT-calculated volumes at different measurement intervals, with the smallest difference at an interval of 5 cm (<i>Z</i> = -4.664, <i>p</i> < 0.001). Also, good consistency and correlation were shown at 5 cm (intraclass correlation coefficient = 0.971, <i>r</i> = 0.993, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>This study confirms the feasibility and effectiveness of applying upper limb volume formulas to lower limb volume measurement. From a clinical perspective, we recommend a measurement interval of 5 cm as the optimal choice.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"15578585261473404"},"PeriodicalIF":1.7,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Ultrasound Technique for Assessing Fibrosis in Subcutaneous Fat in Lymphedematous Limbs.","authors":"Hisako Hara, Makoto Mihara","doi":"10.1177/15578585261477183","DOIUrl":"https://doi.org/10.1177/15578585261477183","url":null,"abstract":"<p><strong>Background: </strong>There is no standardized method for identifying fibrosis in the subcutaneous tissue of lymphedematous limbs. This study evaluated the relationship between ultrasonographic findings and fibrosis severity in patients with lower limb lymphedema.</p><p><strong>Methods: </strong>A retrospective analysis included 92 sites in 40 limbs of 26 female patients undergoing lymphaticovenous anastomosis. Skin thickness and subcutaneous echogenicity were assessed preoperatively using an 18-MHz linear ultrasound probe and classified into four grades (U0-U3). Fibrosis severity was evaluated intraoperatively and classified into five grades (F0-F4). Receiver operating characteristic (ROC) curve analysis determined the diagnostic accuracy of skin thickness for predicting severe fibrosis (F3/F4), and a regression model was developed to predict fibrosis severity.</p><p><strong>Results: </strong>Skin thickness was significantly greater in the calves (2.7 mm) than in the thighs (2.1 mm, <i>p</i> < 0.01) and increased with lymphedema stage. Fibrosis severity was higher above the superficial fascia and more prevalent in calves (<i>p</i> < 0.01). ROC analysis showed an area under the curve of 0.80 for calf (above the superficial fascia), with a cutoff of 2.65 mm. The regression model (<i>R</i>² = 0.51, <i>p</i> < 0.001) demonstrated that skin thickness and fat echogenicity significantly predicted fibrosis severity: Fibrosis severity = 0.21 + 0.32 × skin thickness (mm) + 0.45 × fat echogenicity grade.</p><p><strong>Conclusions: </strong>Ultrasound-based measurements of skin thickness and fat echogenicity are reliable and noninvasive predictors of fibrosis severity in patients with lymphedema. These findings support the use of ultrasound imaging to guide treatment planning and improve surgical outcomes. However, further validation is needed in diverse populations.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"15578585261477183"},"PeriodicalIF":1.7,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction Models for Lower Limb Lymphedema after Surgery in Patients with Gynecological Malignancies: A Systematic Review.","authors":"Hongli Li, Yawen Zhang, Wen Li, Hong Yang","doi":"10.1177/15578585261470704","DOIUrl":"https://doi.org/10.1177/15578585261470704","url":null,"abstract":"<p><p>The incidence of gynecological malignancies continues to increase worldwide. Lower limb lymphedema is perhaps the most dreaded long-term complication related to gynecological malignancy surgery. Identifying the early risk factors for lower limb lymphedema can facilitate targeted prevention and improve the prognosis of patients. To systematically review and evaluate existing studies on prediction models for lower limb lymphedema after surgery in patients with gynecological malignancies. PubMed, Embase, Web of Science, the Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, China Biomedical Literature Database, ProQuest Dissertations & Theses, medRxiv, and Google Scholar were systematically searched from inception to December 1, 2024. Studies were appraised critically, and data were extracted by two authors independently based on the Prediction Model Risk of Bias Assessment Tool and Data Extraction for Systematic Reviews of Prediction Modeling Studies. A total of 9 studies were included, involving 10 relevant prediction models. Five studies reported calibration; validation involved internal (<i>n</i> = 7) or both (<i>n</i> = 2). Discrimination varied across models (the area under the curve [AUC] range: 0.63-1.00), with 9 of 10 models reporting AUC values >0.70. However, calibration reporting was incomplete, and all studies were rated as high risk of bias. Although all studies demonstrated good applicability, all were rated as high risk of bias. Across all included studies, age, body mass index, hypertension, diabetes, tumor stage, postoperative drainage time, lymph node dissection, and radiotherapy were the most frequently reported predictors. Among them, lymph node dissection-related variables were included in eight of the ten models, while radiotherapy was included in 7 of 10 models. Although several models reported moderate to good discrimination, overall methodological quality was limited. The predominance of high risk of bias, scarce external validation, and restricted geographic diversity constrains the strength of the current evidence. More rigorously designed and externally validated models are needed before routine clinical implementation.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"15578585261470704"},"PeriodicalIF":1.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphedema and Alzheimer's Disease: Connecting Through the \"Peripheral-Central Lymphatic System\".","authors":"Xinxin Wang, Yilan Li, Jianping Ye, HongKai Lian, Teng Li, Jingxin Wang","doi":"10.1177/15578585261471251","DOIUrl":"https://doi.org/10.1177/15578585261471251","url":null,"abstract":"<p><p>The connection between the peripheral lymphatic system (PLS) and the central lymphatic system (CLS) plays a crucial role for the overall circulatory system. Notably, there are several similarities between lymphedema and Alzheimer's disease (AD). Accumulating evidence suggests that lymphedema might be associated with AD, potentially influencing its progression through mechanisms related to the peripheral-central lymphatic circulation. This review summarizes the lymphatic system's structure, function, and drainage pathways, emphasizing how aging and blockage of the CLS can exacerbate the progression of AD. Additionally, we discuss the relationship between lymphedema and AD, highlighting the significance of the PLS-CLS and exploring lymphaticovenous anastomosis as a promising treatment for both lymphedema and AD.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"15578585261471251"},"PeriodicalIF":1.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Responsiveness of Ultrasonographic Subcutaneous Tissue Parameters to Complex Decongestive Therapy in Breast Cancer-Related Lymphedema.","authors":"Esra Giray, Esra Nur Türkmen, İlker Yağcı, Gülseren Akyüz","doi":"10.1177/15578585261473403","DOIUrl":"https://doi.org/10.1177/15578585261473403","url":null,"abstract":"<p><strong>Background: </strong>Ultrasonographic subcutaneous tissue parameters have previously been used as outcome measures in the evaluation of breast cancer-related lymphedema (BCRL). However, their ability to detect clinically meaningful changes-referred to as responsiveness-has not yet been examined. This study aimed to investigate the responsiveness of ultrasonographic subcutaneous tissue thickness measurements, subcutaneous echogenicity (SEG), and subcutaneous echo-free space (SEFS) changes.</p><p><strong>Methods and results: </strong>Forty patients with International Society of Lymphology Stage 2-3 unilateral lymphedema underwent phase 1 complex decongestive therapy three times weekly for 4 weeks. Ultrasonographic subcutaneous tissue thickness, SEG, and SEFS, alongside circumferential measurements, limb volume, and visual analog scale scores for pain, heaviness, and tightness, were evaluated pre- and posttreatment. Significant symptomatic improvement was observed (<i>p</i> < 0.0001). Edema volume and percentage decreased significantly (<i>p</i> = 0.012 and <i>p</i> = 0.006). Subcutaneous tissue thickness significantly decreased at the upper arm medial, medial epicondyle, and wrist (<i>p</i> < 0.02), demonstrating the highest responsiveness (effect size = 1.74). In contrast, changes in SEG and SEFS were statistically significant only at limited sites and showed small to negligible responsiveness overall; however, SEFS showed comparatively higher responsiveness at the wrist, the site with the greatest baseline free-fluid accumulation. Circumferential and volumetric measures showed low responsiveness.</p><p><strong>Conclusion: </strong>Subcutaneous tissue thickness was the most sensitive ultrasonographic marker in BCRL, followed by symptom scores. SEG and SEFS showed limited overall responsiveness, although SEFS remained meaningful at the wrist. Edema volume and percentage showed greater responsiveness than overall limb volume and circumferential measurements. Integrating subcutaneous thickness with edema-specific and symptom assessment may enhance monitoring of therapeutic outcomes.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"15578585261473403"},"PeriodicalIF":1.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Watershed of Collecting Lymphatic Vessels of The Hip; Between Back and Thigh.","authors":"Hayahito Sakai, Toko Umamoto, Maya Kanasaki, Reiko Tsukuura, Takumi Yamamoto","doi":"10.1177/15578585261461969","DOIUrl":"https://doi.org/10.1177/15578585261461969","url":null,"abstract":"<p><strong>Background: </strong>Gluteal lymphedema is often developed by proximal edematous type of lower extremity lymphedema (LEL) and severe LEL. This study aimed to clarify the watershed of collecting lymph vessels in the gluteal region using indocyanine green (ICG) lymphography.</p><p><strong>Methods: </strong>Medical records of cancer survivors who underwent ICG lymphography for secondary lower lymphedema screening from November 2020 to September 2023 were reviewed. Non-lymphedematous limbs without a dermal backflow pattern on ICG lymphography (ICG stage 0) were included. 0.1 mL of ICG was injected intradermally at five points; the tip of the coccygeal bone, the gluteal fold, the crosspoint connecting those points and the mid-lateral thigh, and the midpoints of them in a prone position and named H₁-H₅ from medial to lateral. Based on ICG lymphography findings, the posteromedial and posterolateral pathway directions of collecting lymph vessels, shown as linear patterns, from each point were investigated.</p><p><strong>Results: </strong>A total of 20 limbs of 15 cancer survivors were included. The posterolateral pattern lymphatic pathway from H₁/H₂/H₃/H₄ was observed in 16/15/3/4 limbs. The posteromedial pattern lymphatic pathway from H₂/H₃/H₄/H₅ was observed in 13/15/18/10 limbs. Anteromedial pattern lymphatic pathway from H₅ was observed in 6 limbs.</p><p><strong>Conclusions: </strong>Multiple ICG injections enhanced the watershed line of collecting lymphatic vessels in the gluteal region, which would be affected for gluteal lymphedema diagnosis and treatment.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"15578585261461969"},"PeriodicalIF":1.7,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Formulation and Characterization of Patent Blue Dye Nanoliposome Labeled with ^99mTc-HMPAO and <i>In Vivo</i> Evaluation by Sentinel Lymph Node Mapping.","authors":"Najmeh Heidari, Hamideh Abbasian, Pegah Sahafi, Atena Aghaee, Somayeh Beheshti, Azam Abbasi, Ali Badiee, Seyed Rasoul Zakavi, Mahmoud Reza Jaafari, Ramin Sadeghi, Kayvan Sadri","doi":"10.1177/15578585261419374","DOIUrl":"10.1177/15578585261419374","url":null,"abstract":"<p><strong>Objective(s): </strong>Sentinel lymph node (SLN) mapping commonly involves presurgical administration of a radioactive colloid and intraoperative injection of a blue dye near the tumor. Combining gamma scintigraphy and visual inspection could reduce false-negative rates. This study introduces novel imaging agents-radioactive nanoliposomes (NLs) encapsulating patent blue dye-for lymph node scintigraphy.</p><p><strong>Materials and methods: </strong>PEGylated (PEG-NLs) and non-PEGylated (non-PEG-NLs) NLs were prepared using the thin-film hydration method with patent blue dye and labeled with ^99mTc-hexamethylpropylene-amine-oxime (^99mTc-HMPAO). Lymphatic drainage of the radiolabeled liposomes was assessed in BALB/c mice following subcutaneous footpad injections. Planar imaging was performed at 0.5 and 1 hour postinjection.</p><p><strong>Results: </strong>The mean diameter, zeta potential, and polydispersity index of the PEG-NLs were 130.7 ± 0.348 nm (<i>n</i> = 3), -22.4 ± 0.54 mV, and 0.118 ± 0.12, respectively. These values for the non-PEG-NLs were 120.46 ± 0.506 nm (<i>n</i> = 3), 7.5 ± 0.65 mV, and 0.055 ± 0.009, respectively. ^99mTc-HMPAO-PEG-NLs had a significantly higher lymph node uptake at earlier times after injection (28.27 ± 5.22% ID/g at 1 hour and 16.65 ± 4.23% ID/g at 2 hours), which was followed by fast washout at 4 hours postinjection and showed fast migration of PEGylated NLs through lymphatic system. ^99mTc-HMPAO-non-PEG-NLs had an increased lymph node accumulation through entire time after injection (11.95 ± 0.8% ID/g, 22.95 ± 4.56% ID/g, 29.71 ± 2.16% ID/g at 1, 2, and 4 hours, respectively). Encapsulation efficiency of patent blue dye was determined to be 1.26 ± 0.1%.</p><p><strong>Conclusion: </strong>^99mTc-HMPAO PEG-NLs and non-PEG-NLs containing Paten Blue dye are promising agents for SLN mapping, offering distinct advantages in uptake kinetics and retention for lymphatic imaging and visual detection.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"138-144"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipedema: Exploring Relationship Between Physical and Psychological Symptoms in Affected Patients-A Mixed-Methods Study.","authors":"Bastien Seynhaeve, Velika Stoichkova, Jean-Paul Belgrado, Estelle Janssens, Eline Lison, Jennifer Foucart","doi":"10.1177/15578585261454789","DOIUrl":"10.1177/15578585261454789","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have consistently shown that patients with lipedema are at a higher risk for depression and anxiety. The aim of this study is to identify the psychological factors associated with lipedema syndrome (LS) and their link to the patient's psychological symptomatology.</p><p><strong>Methods: </strong>A mixed-methods approach was employed, combining quantitative and qualitative components. The quantitative component involved anonymous online questionnaires, including a Health and Demographic Questionnaire, the body satisfaction and global self-perception questionnaire (BSGSPQ), the lymphedema quality of life questionnaire (LYMQOL), and the Hospital Anxiety and Depression Scale (HADS). The qualitative component consisted of oral interviews to explore the complexity of the phenomenon. Participants included those with \"easy bruising,\" a waist-to-hip ratio ≤0.7 (W/H), and pain levels ≥4/10 on the visual analogue scale (VAS).</p><p><strong>Results: </strong>Our findings indicate that the level of depression is positively correlated with spontaneous pain (<i>p</i> = 0.002; <i>r</i> = 0.331) and the lack of medical understanding (<i>p</i> = 0.011; <i>r</i> = 0.229). Anxiety scores are inversely correlated with body satisfaction (<i>r</i> = -0.317) and global self-perception (<i>r</i> = -0.393); similarly, depression scores show similar correlations with body satisfaction (<i>r</i> = -0.445) and global self-perception (<i>r</i> = -0.608), all with <i>p</i> value of <0.0001.</p><p><strong>Discussion and conclusion: </strong>This study highlights significant connections between the physical symptoms and mental health in patients with LS. The more affected the self-perception, the greater the depression and anxiety levels. These multiple contributing factors may explain the decline in quality of life (QOL) and deterioration of mental health. It is therefore crucial to proactively integrate mental health management into the care of LS patients. Future research should focus on identifying concrete, actionable methods to support women experiencing LS.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"180-187"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathophysiological Changes in Primary Lymphedema: A Comprehensive Analysis of Histological and Molecular Alterations and Lymphatic Reconstruction Outcomes.","authors":"Jacqueline Plau, Carlo Cassina, Stefan Wolf, Lisanne Grünherz, Carmen E Zurfluh, Pietro Giovanoli, Epameinondas Gousopoulos, Nicole Lindenblatt","doi":"10.1177/15578585261452772","DOIUrl":"10.1177/15578585261452772","url":null,"abstract":"<p><strong>Background: </strong>Primary lymphedema is a rare, chronic condition characterized by impaired lymphatic function, leading to the development of edema. It is caused by genetic mutations affecting lymphatic vessel development, and its clinical presentation is highly variable. While research has focused on identifying genetic causes, the underlying pathophysiology remains poorly understood, limiting the efficacy of available therapeutic strategies. In this monocentric case-control study, we investigate the histological and molecular characteristics of primary lymphedema patients and microsurgical outcomes.</p><p><strong>Methods and results: </strong>Biopsies from affected and unaffected extremities of 15 primary lymphedema patients undergoing lymphatic reconstructive surgery were collected, analyzed, and compared with eight healthy control samples. Histological and molecular markers were assessed on skin and fat samples, respectively. In addition, clinical data, pre- and postoperative volume measurements, and patient-related outcomes following lymphatic reconstructive surgery were evaluated. Our findings reveal significantly reduced cutaneous fibrosis as well as downregulation of <i>CLDN5</i> and <i>VEGFD</i> expression in primary lymphedema patients. Notably, expression of <i>TJP1</i> was significantly decreased in the affected, but not the unaffected side of these patients. Microsurgical outcomes, including volume loss and patient-reported quality of life measures, showed notable variability, being inconclusive.</p><p><strong>Conclusions: </strong>Our findings highlight a distinct pathophysiological profile in primary lymphedema, characterized by unexpected extracellular matrix alterations and increased vascular permeability, both locally and systemically. These insights improve our understanding of the disease mechanisms and potentially suggest a novel link between lymphatic dysfunction and fibrosis development. Further research is needed to address the demand for individualized treatment strategies.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"153-162"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148031709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropathic Pain Features in Lipedema Compared to Lymphedema: An Exploratory Cross-Sectional Study.","authors":"Seçil Pervane, Öznur Uzun","doi":"10.1177/15578585261454778","DOIUrl":"10.1177/15578585261454778","url":null,"abstract":"<p><strong>Background: </strong>Lipedema is a chronic connective tissue disorder characterized by painful subcutaneous adipose accumulation, mainly in the lower extremities. Pain is a hallmark feature, yet its mechanisms remain poorly defined. Neuropathic components may contribute, but direct comparisons with lymphedema are scarce.</p><p><strong>Methods: </strong>In this exploratory cross-sectional study, 118 female patients with lipedema (<i>n</i> = 62) or bilateral lower extremity lymphedema (<i>n</i> = 56) were assessed. Pain intensity was measured with the Visual Analogue Scale (VAS). Neuropathic pain was evaluated with painDETECT and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). Psychological status was measured using the Hospital Anxiety and Depression Scale (HADS), cognitive-emotional aspects with the Pain Catastrophizing Scale (PCS), and health-related quality of life with the WHOQOL-BREF.</p><p><strong>Results: </strong>Lipedema patients reported higher pain severity (VAS 6.2 ± 1.4 vs. 5.5 ± 1.5, <i>p</i> = 0.02) and greater neuropathic pain prevalence (42% vs. 21%, <i>p</i> < 0.01) than lymphedema. painDETECT and LANSS scores were significantly higher in lipedema (<i>p</i> < 0.001). HADS-Anxiety (10.2 ± 3.8 vs. 7.8 ± 3.5, <i>p</i> = 0.005) and PCS scores (29.5 ± 7.2 vs. 25.4 ± 6.5, <i>p</i> = 0.03) were also elevated, while HADS-Depression was slightly higher in lymphedema without significance. WHOQOL-BREF scores were similarly reduced in both groups compared to population norms. Correlation analyses showed strong associations between pain intensity, neuropathic features, catastrophizing, and anxiety, particularly in lipedema.</p><p><strong>Conclusions: </strong>A substantial proportion of lipedema patients exhibit neuropathic pain features and higher pain severity compared with lymphedema, while anxiety and pain catastrophizing appear to amplify symptom burden; however, quality-of-life impairment is substantial in both conditions, and the findings should be interpreted as hypothesis-generating with implications for more individualized management approaches.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"174-179"},"PeriodicalIF":1.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}