Differential Diagnosis of Deep Vein Thrombosis and Lower Limb Lymphedema

Lymphedema and deep vein thrombosis (DVT) are critical conditions that must be differentiated in patients presenting with lower extremity edema. Both conditions are typically characterized by unilateral swelling; however, DVT tends to manifest with more acute symptoms, such as redness and pain. When DVT is suspected, the diagnostic approach includes an initial assessment of clinical probability and screening with D-dimer testing, followed by imaging modalities such as compression ultrasound or CT/MR venography. Recently, direct oral anticoagulants (DOACs) have been preferred as a treatment for DVT, but depending on the patient's underlying disease or the severity of venous thromboembolism, a different therapeutic approach may be required. The incidence of both DVT and lymphedema is notably higher in cancer patients compared to the general population. Additionally, there is the potential for tumors to compress blood vessels or lymphatic structures, complicating diagnosis. Given that D-dimer reliability may be reduced in this population, a thorough consideration of all differential possibilities is essential in managing these patients.