Lymphedema: From Pathogenesis to Treatment

A special issue of Lymphatics (ISSN 2813-3307).

Deadline for manuscript submissions: 31 December 2026 | Viewed by 286

Special Issue Editor


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Guest Editor
Cardiovascular Research Center, Massachusetts General Hospital-Harvard Medical School, Boston, MA 02114, USA
Interests: lymphatic biology; lymphedema; exercise; gut microbiome; circulation

Special Issue Information

Dear Colleagues,

Lymphedema arises from insufficiency in lymphatic transport and progresses through an integrated cascade of lymphatic vascular dysfunction, immune activation, stromal remodeling, and adipose tissue expansion. Although clinical management has advanced, validated mechanistic biomarkers and disease-modifying therapies remain limited, reflecting critical gaps in our understanding of how lymph flow, valve integrity, collecting vessel contractility, and lymphatic endothelial–stromal crosstalk deteriorate over time. This Special Issue, “Lymphedema: From Pathogenesis to Treatment,” aims to highlight robust mechanistic and translational studies that bridge fundamental lymphatic biology with therapeutic innovation.

We invite original research and reviews addressing genetic and epigenetic determinants of primary lymphedema, as well as post-surgical, radiation- and inflammation-induced secondary lymphedema. Particular emphasis is placed on the roles of lymphatic endothelial cells, lymphatic muscle cells, perivascular nerves, immune cells, fibroblasts, and adipocyte progenitors in disease initiation and progression. Topics of interest include mechanotransduction and shear stress signaling, valve remodeling, neuro-immune regulation of collecting lymphatic pumping, extracellular matrix fibrosis, and adipose tissue reprogramming. Studies employing intravital imaging, single-cell or spatial omics, functional lymphatic assays, and well-characterized patient cohorts are strongly encouraged. We also welcome contributions on emerging therapeutic strategies, including pharmacological targets, exercise and rehabilitation paradigms, microsurgical approaches, and gene- or cell-based therapies.

Dr. Kangsan Roh
Guest Editor

Manuscript Submission Information

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Keywords

  • lymphedema
  • lymphatic transport insufficiency
  • collecting lymphatic vessel contractility
  • lymphatic valve remodeling
  • mechanotransduction and shear stress signaling
  • immune–lymphatic interactions
  • stromal remodeling and fibrosis
  • adipose tissue deposition and reprogramming
  • intravital imaging
  • single-cell and spatial omics

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Published Papers (1 paper)

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Review

15 pages, 6734 KB  
Review
A Narrative Review of Lymphedema Following Head and Neck Cancer Treatment
by Micah K. Harris, Joshua D. Smith, Jenny Kim, Wesley Cai, Kevin J. Contrera, Steven B. Chinn, Marci L. Nilsen, Shaum S. Sridharan and Matthew E. Spector
Lymphatics 2026, 4(2), 30; https://doi.org/10.3390/lymphatics4020030 - 11 Jun 2026
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Abstract
Head and neck lymphedema (HNL) is a common complication of head and neck cancer (HNC) treatment. Surgery and radiation, the backbones of HNC treatment, disrupt lymphatic networks through direct injury and fibrosis, leading to accumulation of lymphatic fluid in interstitial spaces. This causes [...] Read more.
Head and neck lymphedema (HNL) is a common complication of head and neck cancer (HNC) treatment. Surgery and radiation, the backbones of HNC treatment, disrupt lymphatic networks through direct injury and fibrosis, leading to accumulation of lymphatic fluid in interstitial spaces. This causes swelling of external and internal structures, leading to decreased quality of life, cosmetic distress, social withdrawal, and functional deficits such as dysphagia, dysphonia, and reduced cervical mobility. In this narrative review, we provide a broad overview of the pathophysiology, assessment, and prevention of HNL. Key surgical factors include the extent of neck dissection, including specific levels removed. Radiation compounds surgical injury through lymphatic fibrosis in a dose-dependent manner. Emerging radiation de-escalation strategies may reduce HNL, though lymphedema is rarely studied as a trial endpoint. Moreover, assessment of HNL remains challenging due to the absence of a gold standard—patient-reported outcome measures, clinician-reported scales, and instrumental tests each capture distinct components of external and internal HNL. Currently, the cornerstone of HNL treatment is conservative management with complete decongestive therapy, which shows mixed efficacy and does not address internal HNL. Surgical options including lymphovenous anastomosis and vascularized lymph node transfer show early promise but remain limited to case reports and small series. Lymphatic imaging, particularly indocyanine green lymphography, represents a promising emerging modality for guiding personalized treatment planning, though application to the head and neck remains challenging. Ultimately, current management of HNL remains largely reactive, with a noticeable lack of preventative therapies. Future research may benefit from better defining surgical options, including HNL as an endpoint in radiation de-escalation trials, and validate emerging lymphatic imaging techniques in order to improve outcomes for HNC survivors. Full article
(This article belongs to the Special Issue Lymphedema: From Pathogenesis to Treatment)
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