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As a part of the initial work-up before diagnosing lymphedema, it may be necessary to exclude other potential causes of lower extremity swelling such as renal failure, hypoalbuminemia, congestive heart-failure, protein-losing nephropathy, pulmonary hypertension, obesity, pregnancy and drug-induced edema.
Causes of secondary lymphedema. Any condition or procedure that damages your lymph nodes or lymph vessels can cause lymphedema. Causes include: 1  Surgery. 2  Removal of or injury to lymph nodes and lymph vessels may result in lymphedema. 3  For example, lymph nodes may be removed to check for spread of breast cancer, and lymph nodes may be injured in surgery that involves blood vessels in your limbs. 4  Radiation treatment for cancer.