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.

SUBCLAVIAN-JUGULAR ANGLE

It is formed by the junction between the left internal jugular vein and the left subclavian vein. It is where the thoracic duct ends and where it flows into the venous system, with the lymph it contains.

STEWART-TREVES SYNDROME

Eponym used to define chronic lymphedema and the subsequent overlapping of angiosarcoma grown out of lymphatic endothelium (see also Lymphangiosarcoma).

STEMMER SIGN

Pathognomonic sign in lymphedema semeiotics, featuring – in the extremity affected by lymphatic stasis – a thickened skin fold at the base of the second toe which cannot be lifted. It is due to fibrous-sclerotic involution processes of subcutaneous tissues.

SHORT STRETCH FUNCTIONAL BANDAGES

This is the most popular and effective medical-physical treatment of limb lymphostasis and related disorders, such as for example acute lymphangitis. In chronic patients, it is often replaced with compression stockings (that patients can handle more easily), which have the same function of bandages, especially with reference to their compression action, but which, even when made to order, cannot be as resilient and effective as daily fashioned bandages. For this reason, some physicians and physiotherapists teach patients to apply these bandages themselves at home, often in association with mechanical lymphatic drainage also done at home. Lymphedema bandages are defined as “short stretch-functional”, because they must permit the affected extremity to move comfortably, thus supporting the physical-elastic drainage function of the bandage in a non-traumatic way. There are many different ways and techniques to fashion these bandages: normally, a multi-layer approach is recommended, namely on top of a first layer of foam or padding material, for protection and remodeling, several layers of mostly short stretch bandages are applied, to modulate compression action. In acute lymphangitis therapy, conventional short-stretch functional bandages may be coupled with medicated paste bandages, containing zinc oxide and other antibiotic-cortisone substances.

SENTINEL LYMPH NODE

A modern technique, mostly developed thanks to progress in radioisotopic technology, only recently has it become part of standard clinical practice. Following injection of a lymphotropic radioactive tracer – the same as the one used in lymphoscintigraphy – coupled with a portable gamma-camera, preferential lymphatic drainage pathways are detected, with a good level of accuracy, as well as reference lymph nodes for a specific body region, generally close to the site of a malignant tumor (the “sentinel” lymph node is the first drainage lymph node). The goal is to support the surgeon in performing a surgical lymphadenectomy by targeting lymphatic-lymph node structures at a higher risk of tumor invasion, while limiting surgical invasiveness, and, indirectly, reducing its complications.

S.I.L.

Società Italiana di Linfangiologia. Founded in 1965 by Prof. Egidio Tosatti, in 1989 it joined the “Latin-Mediterranean Chapter (LMC) of ISL”. Its official journal is the “European Journal of Lymphology and Related Problems (EJLRP)”, the same journal as “G.E.L.”  and “LMC-ISL”.

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