Lymphology Association of North America (LANA) Practice Exam

In evaluating a patient presenting with edema, what condition must be ruled out before starting CDT?

1. Primary lymphedema

2. Myxedema

3. Hypoproteinemia

4. Malignant lymphedema

The correct answer is: Malignant lymphedema

When evaluating a patient with edema before initiating Complex Decongestive Therapy (CDT), it is crucial to rule out malignant lymphedema. This condition is associated with cancer and can complicate the management of edema. Malignant lymphedema arises from the disruption of normal lymphatic drainage due to tumor growth or metastatic disease, which can lead to significant complications if CDT is applied without thorough diagnosis. Starting CDT in a case of malignant lymphedema could inadvertently worsen the patient’s condition, potentially accelerating the progression of cancer-related complications or increase the risk of infection in already compromised lymphatic systems. Therefore, confirming that the edema is not due to malignancy ensures the safety and appropriateness of the treatment plan. In the context of other conditions, while primary lymphedema, myxedema, and hypoproteinemia are important considerations in the differential diagnosis of edema, they do not carry the same level of risk for immediate complications associated with starting CDT. Understanding the underlying cause of edema is fundamental, but malignant lymphedema must always be ruled out first to ensure safe treatment intervention.