Lympho-nodal fibrosclerosis in primary lymphedema. Part one: Considerations on lympho-nodal fibrosclerosis in primary lymphedema.

Segments of an inferior inguinal ganglion and of an external iliac (upper inguinal) ganglion were microscopically examined in 46 cases of bilateral primary lymphedema and 26 cases of unilateral primary lymphedema. The examination was performed bilaterally and comparatively to a set of ganglions unaffected by lymphedema, during the years 1974-1978. In all the lymph nodes originating from the patients with lymphedema important morphopathological alternations were noticed, chiefly consisting in fibrosis, fibrosclerosis, fat loading, hyalinization processes, giganto-cellular responses, etc., leading even to an aspect of cirrhosis, lympho-nodal pseudo-cirrhosis. These alterations were also found on the healthy side of the patients with unilateral primary lymphedema at the time of the microscopical examination. In the same patient clinical edema appeared in the following years. The degree of the morphopathological alterations was greater in the side of the greater edema and more peculiar in the cases of bulkier edema.