Effect of Obesity on Lymphatic Fluid Filtration in Inguinal Lymph Nodes

Abstract

Objective: The objective of this study was to investigate the potential impact of radionuclide imaging on filtration in the inguinal lymph nodes of obese patients. We aimed to compare the lymphatic transport after the inguinal lymph nodes between obese patients and normal-weight individuals, while ensuring intact lower extremity lymphatic flow.

Methods: A retrospective study design was employed, involving the re-evaluation of patient images. Among the total of 119 patients, 62 were classified as obese, while the remaining patients had body mass indexes within normal limits. All patients included in the study were female, with a mean age of 39 years (ranging from 28 to 47 years). Lymphatic imaging was performed using Tc-99m-labeled nanocolloid particles with a size of 50-70 nm. The nanocolloid was applied to the 1st and 2nd interdigital web areas on the dorsum of both feet. Late images were captured at 45-50 minutes and 2 hours after application.

Results: Out of the 119 patients, 62 (52%) were classified as obese. There was no significant difference in terms of age between the two groups. The pre-inguinal average count values, calculated from the counts before the inguinal node, did not show a significant difference between the two groups. However, the post-inguinal average count values obtained after the inguinal nodes were significantly lower in obese patients compared to normal-weight patients (p<0.0005).

Conclusion: Our findings suggest that even in the early stages, when functional imaging allows observation of the main lymphatic duct, there are differences in the progression of lymphatic flow between obese patients and normal-weight individuals. Detecting these differences may enable early diagnosis of lymphedema disease, which is a reversible disorder if identified promptly.