[The lymphatic system-an interdisciplinary challenge].

Background: Congenital and acquired diseases as well as iatrogenic injuries to the lymphatic system pose significant differential diagnostic challenges for both diagnostic and interventional radiology. With the new diagnostic options and minimally invasive therapies, radiology has a central role in the clinical workflow of these diseases.

Aim: This work is intended to provide an overview of the differential diagnostic spectrum and explain possible workflows, outlining which diagnostic procedures can be used in which sequence, and what options for minimally invasive therapies exist for the individual diseases.

Methods: For this purpose, appropriate overviews of various entities and differential diagnostic workflows were compiled and options for corresponding clinical pathways are presented.

Results: Injuries and diseases of the lymphatic system cover a broad differential diagnostic spectrum. The classification of the corresponding entity on the basis of patient history, clinical presentation, and imaging is crucial to effectively employ specific diagnostic procedures such as magnetic resonance (MR) lymphography or transnodal fluoroscopic lymphangiography. The latter simultaneously allows the combination with minimally invasive therapeutic approaches, including both recanalizing and embolization or sclerosing techniques. Interdisciplinary approaches and care for patients with complex illnesses in specialized centers offer advantages for care, analogous to oncology.

Conclusion: New methods in both diagnostic lymphangiography and therapeutic minimally invasive interventions pose new challenges for radiology, which should be met in an interdisciplinary setting, especially in patients with complex situations.