Fig. 2.

Four-limb ICG lymphography scan of a 72-year-old woman with primary lymphedema, initially reporting swelling only in left leg. A, ICG signal stagnation in the proximal left lower leg, failing to reach the groin. B, ICG signal arrested in the mid-right lower leg. C, Right arm showing ICG signal halting in the mid-upper arm. D, Left arm showing ICG signal prematurely terminated at the elbow and at the mid-upper arm. After the patient was made aware of her systemic, 4-limb functional impairment, she reported mild but recurrent swelling in both hands, exacerbated by repetitive movements. This case underscores the importance of thorough ICG evaluation, as initial patient reports may overlook less pronounced symptoms of lymphedema.