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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.
1 Lymphedema is the build-up of fluid in soft body tissues when the lymph system is damaged or blocked. 2  The lymph system is a network of lymph vessels, tissues, and organs that carry lymph throughout the body. 3  Lymphedema occurs when lymph is not able to flow through the body the way that it should. Secondary lymphedema is caused by damage to the lymph system. 2  The lymph system may be damaged or blocked by infection, injury, cancer, removal of lymph nodes, radiation to the affected area, or scar tissue from radiation therapy or surgery.