Clam Digger's Legs

Mike LaCombe, a cardiologist from Maine, has a question for our panel.

"G.M. is a 48 y.o. clam digger from Maine. These individuals are exposed to avian schistosomiasis, and on a web search, the consequent clam-digger’s itch has been rarely associated with lymphedema.

Sorry, I have no pictures. This man has well-documented lymphedema of the lower extremities for six months.

All studies negative: CT scans of pelvis, abdomen, chest, ultrasound of leg veins, cardiac echo ruling out any cor pulmonale, and labs showing no evidence of liver disease, hypoalbuminemia.

My questions are:
1. Does anyone have any experience with this?
2. Any specific tests to confirm the diagnosis?
3. Therapy suggestions? "

There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy." Always something new.