“…Lymphedema under such circumstances is thought to be due to the development of inflammation and possible fibrosis of the superficial lymph vessels as complications of synovitis, with subsequent obstruction of lymphatic flow due to lymph node swelling, etc. 2,4,5,12,13 However, it has been reported that some of the patients did not show any correlation between severity of lymphatic impairment and duration or severity of arthritis, 4,5 suggesting that local factors other than lymphatic function may influence the threshold below which edema occurs. Casley-Smith and Piller have reported that lymphedema was partially derived from the failure of macrophages to absorb protein in the tissue fluid.…”