MICROLYMPHATIC ANEURYSMS IN PATIENTS WITH LIPEDEMA

Abstract

"Lipedema," a special form of obesity syndrome, represents swelling of the legs due to an increase of subcutaneous adipose tissue. In 12 patients with lipedema of the legs and in 12 healthy subjects (controls), fluorescence microlymphography was performed to visualize the lymphatic capillary network at the dorsum of the foot, at the medial ankle, and at the thigh. Microaneurysm of a lymphatic capillary was defined as a segment exceeding at least twice the minimal individual diameter of the lymphatic vessel.

In patients with lipedema, the propagation of the fluorescent  dye into the superficial lymphatic network of the skin was not different from  the control group (p>0.05). In all 8 patients  with lipedema of the thigh, microaneurysms were found  at this site (7.9 ± 4.7 aneurysms per depicted network) and in 10 of the 11 patients  with excessive fat involvement of the lower leg, multiple microlymphatic aneurysms were found  at the ankle region. Two obese patients showed lymphatic microaneurysms in the unaffected thigh and in only 4 patients  were microaneu­ rysms found  at the foot. None of the healthy controls exhibited microlymphatic aneurysms at the foot  and ankle, but in one control subject a single microaneurysm was detected in the thigh.

Multiple microlymphatic aneurysms of lymphatic capillaries are a consistent finding in the affected skin regions of patients  with lipedema. Its significance remains to be elucidated although its occurrence appears to be unique to these patients.