Primary lymphedema tarda in an 88-year-old African-American male.
Primary lymphedema tarda is considered to be a congenital disease with delayed manifestations. We report a case of isolated lymphedema of the left upper extremity in an 88-year-old African-American male. The diagnosis of lymphedema was confirmed by lymphoscintigraphy, and appropriate diagnostic studies were done to rule out other known causes of lymphedema. Lymphoscintigraphic findings were consistent with idiopathic primary lymphedema. During the course of investigations, the patient was found to have adenocarcinoma in situ of the sigmoid colon with no evidence of metastatic spread. Based on the available data, we were unable to establish a causative relationship between colonic carcinoma and lymphedema in our patient. Therefore, this case can best be described as a case of Idiopathic primary lymphedema tarda. We emphasize the use of histopathologic examination in the diagnostic algorithm to rule out underlying malignant process only in patients with radionuclide findings suggestive of secondary lymphedema with no obvious etiology.
Aslam
Ahmed Faraz
AF
Department of Internal Medicine, Long Island College Hospital, Brooklyn, NY 11201, USA. ahmedfaslam@hotmail.com
Aslam
Ahmad Kamal
AK
Qamar
Muhammad Umair R
MU
Levey
Robert
R
D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003937:Diagnosis, Differential; D006801:Humans; D008209:Lymphedema / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D014055:Tomography, Emission-Computed; D034941:Upper Extremity / Q000000981:diagnostic imaging / Q000503:physiopathology*