Dizionario

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Although words like lymphocyte, lymph node, lymph, and lymphatic vessels are common in daily medical activities, Lymphology has always been considered as a sort of younger sister to Angiology or Phlebology. Also, apart from few pioneer physicians, it has never been investigated as a discreet, well identified area of research.

Therefore, the following “Dictionary” aims to be a sort of metaphorical “window” on the extensive and still poorly explored world of lymphatic diseases, as well as to provide some useful, basic information for a correct diagnosis of patients affected by lymphatic-lymph node disorders.

Questo “Dizionario” vuole, quindi, rappresentare una sorta di metaforica “finestra” sul vasto ed ancora poco inesplorato mondo della patologia linfatica e fornire utili elementi di conoscenza di base per una corretta diagnosi e gestione del paziente affetto da alterazioni del sistema linfatico-linfonoidale.

ERYSIPELAS

It is an acute inflammation of superficial soft tissues, most frequently caused by Streptococcus pyogenes. Its clinical picture features an erythematous, stinging edema, with sharply demarcated raised edges, which can involve the face or the extremities, and it is often associated with high fever (up to 41° axillary temperatures). It has highly different systemic pictures, rarely does it affect deeper soft tissues, and it is easily resolved when treated with penicillins. After about 5-10 days since the acute episode, massive exfoliation of the involved skin can occur. Patients affected by lymphedema carry a higher risk of developing this infection. In these individuals, lymphangites, although not necessarily linked to infections by Streptococcus pyogenes, present with mixed clinical pictures that are called “erysipeloid lymphangites”.

ENDOTHELIUM

Endothelial cells have a mesenchymal origin and may take up different forms, depending on their lining function, since they can either be continuous or fenestrated. They line the internal (intima) lumen of capillaries, veins, and arteries, as well as of lymphatic vessels and cardiac cavities.

ELEPHANTIASIS

The last, 5th stage of clinical lymphedema of the lower extremities. The limb totally loses its normal anatomic shape and, mostly because of massive edema of the ankle and leg, acquires a cylindrical shape, which looks like an elephant leg. Coupled with this morphostructural dysfunction, also skin anomalies are often present involving sclerotic processes – also called sclerodermic pachidermitis – which make the legs of patients with this condition even more similar to those of elephants.

ELECTROSTIMULATORS

Electrical muscle stimulation, with electrodes placed on the skin, is a method employed since the ’60s to train athletes, and, more recently, it has become quite popular due to the increasing focus on personal body care and physical shape and fitness. It has quickly spread in many aesthetic and physiotherapy centres, and it is also used in lymphatic drainage. Its lymphatic drainage action is allegedly linked to muscle pump stimulation, which, indirectly, is claimed to increase lymphatic drainage. However, this principle, although theoretically faultless, should not be applied to patients with healthy neuro-muscular functions, who can and are supposed to exercise regularly, with subsequent, more complete and physiological activation of the muscular pump. Conversely, this method has proved to be quite effective in helping lymphatic drainage in all those patients who are affected by neuro-muscular, often degenerative, disorders, preventing them from walking normally, and which are frequently the cause of lymphatic stasis also called  functional “disuse” lymphedema” (see). Ongoing investigations in this area on patients affected by multiple sclerosis have already provided encouraging results.

EFSP

Acronym of Edematous-Fibrosclerotic Panniculopathy, presenting with an anatomic-pathologic picture of suprafascial subcutaneous tissue dystrophy, which characterizes the clinical condition that is commonly known as cellulite (see).
Figure: Pictures of the most common localization sites of Edematous-Fibrosclerotic Panniculopathy (EFSP).

EDEMA

It is a symptom defined as a visible and palpable swelling of tissues, caused by the build-up of interstitial fluids. More commonly, it may have an  inflammatory, cardiogenic, lymphatic, venous, renal, or mixed origin.

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