Stages of Lymphedema

Subclinical: Patient begins to feel “heaviness” in limb, fibrotic changes and fluid accumulation can occur before visible swelling or pitting. Approximately 50% of patients with minimal edema report a feeling of heaviness or fullness in the extremity.

Stage 1: Reversible lymphedema: accumulation of protein –rich fluid, elevation reduces swelling. Pits on pressure.

Stage 2: Spontaneously irreversible lymphedema: proteins stimulate fibroblast formation, connective and scar tissue proliferate. Minimal pitting even with moderate swelling.

Stage 3: Lymphostatic elephantiasis: hardening of dermal tissues, papillomas of the skin, appearance elephant-like. (Not everyone progress to this stage.)

Dr. Michael Földi, 1985