Images in Clinical Tropical Medicine Lymphoscintigraphy in Unilateral Lower Limb and Scrotal Lymphedema Caused by Filariasis

Abstract. Lymphedema is the edema that results from chronic lymphatic insufficiency. Lymphatic filariasis is caused by the filarial nematodes Wuchereria bancrofti, Brugia malayi, and Brugia timori. Lymphatic filariasis is common in tropical and subtropical regions. Early diagnosis and prompt therapy can be implemented using lymphoscintigraphy. Our patient is a 15-year-old boy presenting with a 3-month history of hydrocele. The patient was referred to us to rule out any lower limb lymphatic obstruction as the patient is from an endemic area. Tc Sulfur colloid (filtered) lymphoscintigraphy showed abnormal tracer collection in the scrotum and penis. There is associated dermal backflow or stasis in the left thigh region extending just above the knee, suggesting partial obstruction of left inguinal lymphatic channels. Lymphatic filariasis is common in tropical and subtropical regions.1 A 15-year-old boy presented with 3 months of scrotal edema. Although residence in a tropical area raises a high sus-picion for lymphatic filariasis caused by Wuchereria bancrofti, which can usually be diagnosed with an antigen detection card test, this patient was evaluated for lymphatic obstruction. Imag-ing was performed with one millicurie (mCi) of filtered Techne-tium sulfur colloid (Figure 1). Four intradermal injections wer