DOCSLIB.ORG

The Lymphatics in Kidney Health and Disease

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Lymphatics in Kidney Health and Disease REVIEWS The lymphatics in kidney health and disease Michael D. Donnan 1,2, Yael Kenig- Kozlovsky3 and Susan E. Quaggin1,2 ✉ Abstract | The mammalian vascular system consists of two networks: the blood vascular system and the lymphatic vascular system. Throughout the body, the lymphatic system contributes to homeostatic mechanisms by draining extravasated interstitial fluid and facilitating the trafficking and activation of immune cells. In the kidney, lymphatic vessels exist mainly in the kidney cortex. In the medulla, the ascending vasa recta represent a hybrid lymphatic-like vessel that performs lymphatic- like roles in interstitial fluid reabsorption. Although the lymphatic network is mainly derived from the venous system, evidence supports the existence of lymphatic beds that are of non-venous origin. Following their development and maturation, lymphatic vessel density remains relatively stable; however, these vessels undergo dynamic functional changes to meet tissue demands. Additionally, new lymphatic growth, or lymphangiogenesis, can be induced by pathological conditions such as tissue injury, interstitial fluid overload, hyperglycaemia and inflammation. Lymphangiogenesis is also associated with conditions such as polycystic kidney disease, hypertension, ultrafiltration failure and transplant rejection. Although lymphangiogenesis has protective functions in clearing accumulated fluid and immune cells, the kidney lymphatics may also propagate an inflammatory feedback loop, exacerbating inflammation and fibrosis. Greater understanding of lymphatic biology, including the developmental origin and function of the lymphatics and their response to pathogenic stimuli, may aid the development of new therapeutic agents that target the lymphatic system. In mammals, the circulatory system consists of the blood role of dermal lymphatics in fluid homeostasis4 and the and the lymphatic vascular systems, which perform contribution of cardiac lymphatic remodelling to cardio- complementary roles in maintaining body homeostasis. vascular disease and atherosclerosis5. These studies have In contrast to the continuous arterial to venous circuit of also led to the identification and characterization of lym- the blood vascular system, the lymphatic system consists phatic vessels in tissues previously thought to be devoid of a blind-ended network of vessels, which provides uni- of lymphatics. For example, the discovery of meningeal directional, low- flow, transport from peripheral tissues lymphatics in the central nervous system has redefined towards the central venous system. This network trans- our understanding of how the brain responds to inflam- ports interstitial fluid, immune cells, antigens, lipids mation and degeneration6. Hybrid lymphatic-like vessels and associated macromolecules — collectively known have also been discovered in multiple tissues through- 1Feinberg Cardiovascular & as lymph — which is integral to the maintenance of body out the body, including the Schlemm’s canal in the eye7, Renal Research Institute, fluid homeostasis, immune cell trafficking, inflamma- the spiral arteries in the placenta8 and the ascending Northwestern University 1 9 Feinberg School of Medicine, tion and regulation of blood pressure . Despite intensive vasa recta (AVR) within the kidney . In this Review, we Chicago, IL, USA. efforts to extensively detail the blood vascular system discuss the origins and organization of the lymphatic 2Division of Nephrology & in development and disease, the lymphatic system has system and hybrid lymphatic- like vessels, their role in Hypertension, Northwestern historically been overlooked, in part owing to difficulty kidney function and disease and the potential role of the University Feinberg School of in visualizing the typically small and sparse lymphatic lymphatic system as a therapeutic target. Medicine, Chicago, IL, USA. vessels. However, advances in imaging and genetic 3 Department of Nephrology technologies have accelerated our understanding of the Lymphatic structure and organization & Hypertension, Rambam Medical Center, Haifa, Israel. specialized functions of the lymphatic vascular system. The lymphatic system comprises lymphatic vessels, lym- ✉e- mail: quaggin@ These studies have provided insights into unique char- phoid tissues and lymphoid organs that exist through- northwestern.edu acteristics of many organ- specific lymphatic systems, out the body (FIG. 1). A network of highly branched, https://doi.org/10.1038/ including structural characteristics of the intestinal lacte- blind- ended lymphatic capillaries spans almost every s41581-021-00438- y als that underlie their ability to absorb dietary fats2,3, the vascularized tissue, and enables uptake of surrounding NATURE REVIEWS | NEPHROLOGY VOLUME 17 | OCTOBER 2021 | 655 0123456789();: REVIEWS Key points lymphatic vasculature are not uniform throughout the body and may differ between species. For example, • Advances in imaging and genetics technologies have furthered our understanding of the collecting lymphatics of the mouse lung are devoid the role of lymphatic vascular systems in both homeostasis and disease. of smooth muscle cells and fluid flow relies on changes • Key advances include the discovery of hybrid lymphatic-like vessels in multiple tissues in respiratory pressures13, whereas lymphatic flow in the including in the kidney, where the ascending vasa recta express a combination of lungs of sheep seems to be regulated by intrinsic lym- both blood and lymphatic endothelial markers and perform a lymphatic- like role in phatic pumping in addition to passive factors14. These reabsorbing interstitial fluid in the medulla. differences underscore the organ and species- specific • Kidney lymphangiogenesis is strongly associated with injury, inflammation and the heterogeneity of lymphatics. progression of fibrosis. Peripheral lymphatic vessels direct antigen and • Lymphangiogenesis can perform a protective role in clearing the accumulated fluid immune cell- containing lymph towards local draining and immune cells associated with inflammation from the interstitial space; however, 15 the kidney lymphatics also function to propagate an inflammatory feedback loop in lymph nodes (DLNs) . Over 200 DLNs exist throughout coordination with the draining lymph nodes, which may exacerbate inflammation and the human body, the development of which is closely fibrosis. In addition, chronic inflammation can result in the disorganized growth of aligned with those of lymphatic vessels. Within the leaky, poorly functioning lymphatic vessels, further contributing to tissue injury. DLNs, cytokines, immune cells and antigens interact • Targeting the lymphatic system is a potential future direction for new therapeutics with native dendritic cells and recruited leukocytes for kidney disease, and several therapies are undergoing investigation in preclinical within highly specialized lymph node compartments, models. allowing selective filtration of these inflammatory cells • Better understanding of the context- dependent consequences of kidney and molecules, and enabling modulation of the immune lymphangiogenesis, as well as the mechanisms of action and potential off-target response16,17. Lymph then continues through these DLNs consequences of targeting the proposed molecular pathways are needed prior to into larger lymphatic ducts, including the thoracic their clinical use. duct, which eventually returns the lymph to the central circulation18. interstitial fluid and immune cells. Similar to other Lymphatic development and function capillary structures, a single layer of endothelial cells A variety of signalling molecules and pathways coordi- forms the innermost layer of the lymphatic vasculature. nate the development and remodelling of the lymphatic However, in contrast to blood endothelial cells (BECs), vasculature. Several of these pathways are also involved lymphatic endothelial cells (LECs) exhibit unique inter- in development of the blood vasculature; however, spe- cellular junctions that enable enhanced reabsorption cific factors contribute to the determination of the fate of fluid and molecules. In the blind- ended initial lym- of LECs (Table 1). As described below, these unique fac- phatic capillaries, discontinuous, punctate, button- like tors can help to distinguish lymphatic endothelium from junctions anchor the sides of overlapping flaps of oak blood vascular endothelium, and can be used to identify leaf- shaped LECs. Together with the thin, discontinu- potential hybrid structures. ous basement membrane of the lymphatic capillaries and absence of supporting mural cells, these specialized Transcription factors. Prospero- related homeobox junctions are integral to the high permeability of lym- transcription factor 1 (PROX-1) is considered to be phatic capillaries and allow the uptake of fluid and cells the master regulator of lymphatic fate specification. from the surrounding tissues. Loss of these button-like It is expressed by all LECs and is required for their ini- junctions results in impaired capillary permeability and tial differentiation. In mice, PROX-1 is expressed from disruption of fluid uptake2. embryonic day (E) 9.5 by endothelial cells in the ante- The lymphatic capillaries converge towards progres- rior side of the cardinal vein, which give rise to LEC sively larger and fewer collecting lymphatic vessels. The progenitors19. Downregulation of Prox-1 at any stage LECs in collector vessels become more elongated, and during development will induce
Load more

Recommended publications
  • Milky Spots As the Implantation Site for Malignant Cells in Peritoneal Dissemination in Mice1
    ICANCKR RKSEARCH 53. 687-692. February I. 19931 Milky Spots as the Implantation Site for Malignant Cells in Peritoneal Dissemination in Mice1 Akeo Hagiwara,2 Toshio Takahashi, Kiyoshi Sawai, Hiroki Taniguchi, Masataka Shimotsuma, Shinji Okano, Chouhei Sakakura, Hiroyuki Tsujimoto, Kimihiko Osaki, Sadayuki Sasaki, and Morio Shirasu First Department of Surgery. Kyoto Prefectura! University ¡ifMedicine. Kawaramachi-Hirokoji, Kamigyo-ku Kyoto 602, Japan ABSTRACT MATERIALS AND METHODS We examined the site-specific implantation or cancer cells in peritoneal Animals and Cancer Cell Line. Five-week-old male CDF, mice (Shimi/u tissues after an i.p. inoculation of IO5 P388 leukemia cells. Twenty-four h Laboratory Animal Center, Kyoto, Japan) were maintained under standard after the inoculation, the numher of viable cancer cells infiltrating into conditions (specific pathogen free: 22°C;60% relative humidity; 12-h day- specific tissue sites of the peritoneum was estimated by an i.p. transfer night cycle). method. A descending order of tissue implantation with cancer cells was P388 leukemia cells were maintained through i.p. inoculation in DBA2Cr established as omentum > gonadal fat > mesenterium > posterior ab mice (Shimi/.u Laboratory Animal Center). The ascites containing P388 leu dominal wall > stomach, liver, intestine, anterior abdominal wall, and kemia cells was taken from the carrier mouse and suspended in saline at a lung. A significant correlation was established between the logarithm of concentration of IO7 P388 leukemia cells/ml. The viability of the tumor cells, the number of infiltrating cancer cells and the logarithm of the number of as determined by the trypan blue exclusion lest, was greater than 95%.
    [Show full text]
  • Analysis of Human Omentum-Associated Lymphoid Tissue Components with S-100: an Immunohistochemical Study
    Romanian Journal of Morphology and Embryology 2010, 51(4):759–764 ORIGINAL PAPER Analysis of human omentum-associated lymphoid tissue components with S-100: an immunohistochemical study A. YILDIRIM1), A. AKTAŞ2), Y. NERGIZ2), M. AKKUŞ2) 1)Department of Histology and Embryology, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey 2)Department of Histology and Embryology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey Abstract Milky spots are opaque patches in the greater omentum. They were first described by von Recklinghausen (1863) in the omentum of rabbits. In man, milky spots are relatively uniform, highly vascularized accumulations of mononuclear cells. The objective of this study was to describe in human omental lymphoid tissue components with S-100. Tissue samples (greater omentum) were collected from 14 patients operated with different reasons in our Department of General Surgery, in order to histologically present the presence of S-100 in the cells making up the milky spots in human omentum tissue. Tissue samples were cut approximately 5–8 micrometer thick with frozen-sections and stained with an indirect immunoperoxidase technique, as described previously. Then milky spots were examined by light microscopy. These data indicate that unstimulated milky spots in the human greater omentum are to a great extent just a preformed specific accumulation of primarily macrophages within the stroma of the greater omentum, secondarily B- and T-lymphocytes. In addition to these cells, we observed that a few mast and reticular cells were seen in the milky spots by S-100 reactive cross-sections of greater omentum. In the human omentum tissue that was stained with indirect immunoperoxidase method using anti S-100 monoclonal antibody, an arteriole cross-section in the center, reactive nerve cross-sections in the adjacent stroma and endogenic peroxidase reactivity in a few granulocytes in omental tissue were observed.
    [Show full text]
  • Human Anatomy and Physiology
    LECTURE NOTES For Nursing Students Human Anatomy and Physiology Nega Assefa Alemaya University Yosief Tsige Jimma University In collaboration with the Ethiopia Public Health Training Initiative, The Carter Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education 2003 Funded under USAID Cooperative Agreement No. 663-A-00-00-0358-00. Produced in collaboration with the Ethiopia Public Health Training Initiative, The Carter Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education. Important Guidelines for Printing and Photocopying Limited permission is granted free of charge to print or photocopy all pages of this publication for educational, not-for-profit use by health care workers, students or faculty. All copies must retain all author credits and copyright notices included in the original document. Under no circumstances is it permissible to sell or distribute on a commercial basis, or to claim authorship of, copies of material reproduced from this publication. ©2003 by Nega Assefa and Yosief Tsige All rights reserved. Except as expressly provided above, no part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission of the author or authors. This material is intended for educational use only by practicing health care workers or students and faculty in a health care field. Human Anatomy and Physiology Preface There is a shortage in Ethiopia of teaching / learning material in the area of anatomy and physicalogy for nurses. The Carter Center EPHTI appreciating the problem and promoted the development of this lecture note that could help both the teachers and students.
    [Show full text]
  • Structure, Function, and Molecular Control of the Skin Lymphatic System
    CORE Metadata, citation and similar papers at core.ac.uk Provided by Elsevier - Publisher Connector Structure, Function, and Molecular Control of the Skin Lymphatic System Mihaela Skobe and Michael Detmar Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, U.S.A. The mechanisms of angiogenesis have been studied phatic vasculature and the differences between blood extensively over the past years. The focus, however, and lymphatic vessels. Special attention has been has been almost exclusively on blood vessels, whereas given to the methods employed in research of the little effort has been directed toward understanding lymphatic system. Finally, we describe molecular lymphangiogenesis and the role of lymphatic vessels mechanisms involved in the regulation of lymphan- in physiology and pathology. The lymphatic system, giogenesis. Vascular endothelial growth factor and acting in concert with the blood vascular system, is vascular endothelial growth factor-C, expressed by of fundamental importance in maintaining tissue distinct skin cell populations, play an important role homeostasis, and disorders of the lymphatic system in the molecular control of skin angiogenesis and are common, often resulting in chronic, disabling lymphangiogenesis. Key words: lymphatic vessels/lymph- conditions. This overview summarizes the most angiogenesis/skin/VEGF-C. Journal of Investigative important aspects of the structure and function of Dermatology Symposium Proceedings 5:14±19, 2000 the lymphatic system with emphasis on the skin lym- ur understanding of the biology of the lymphatic covered'' (Bartels, 1909). The ancient Greeks observed structures system is well illustrated by the word lymphatic containing colorless ¯uid (Hippocrates spoke of ``white blood'') but itself; the derivation of the latin word lymphaticus their function was not understood and the signi®cance of the signi®es ``distracted and confused'' (Witte et al, ®nding was not recognized.
    [Show full text]
  • Lymphatic Tissue Engineering and Regeneration Laura Alderfer1, Alicia Wei1 and Donny Hanjaya-Putra1,2,3,4,5,6*
    Alderfer et al. Journal of Biological Engineering (2018) 12:32 https://doi.org/10.1186/s13036-018-0122-7 REVIEW Open Access Lymphatic Tissue Engineering and Regeneration Laura Alderfer1, Alicia Wei1 and Donny Hanjaya-Putra1,2,3,4,5,6* Abstract The lymphatic system is a major circulatory system within the body, responsible for the transport of interstitial fluid, waste products, immune cells, and proteins. Compared to other physiological systems, the molecular mechanisms and underlying disease pathology largely remain to be understood which has hindered advancements in therapeutic options for lymphatic disorders. Dysfunction of the lymphatic system is associated with a wide range of disease phenotypes and has also been speculated as a route to rescue healthy phenotypes in areas including cardiovascular disease, metabolic syndrome, and neurological conditions. This review will discuss lymphatic system functions and structure, cell sources for regenerating lymphatic vessels, current approaches for engineering lymphatic vessels, and specific therapeutic areas that would benefit from advances in lymphatic tissue engineering and regeneration. Keywords: Lymphangiogenesis, Tissue Engineering, Disease Modeling, Wound Healing, Lymphedema, Stem Cells, Biomaterials, Interstitial Fluid, Regeneration I. Introduction to the Lymphatic System and its role Interstitial fluid (IF) is a plasma filtrate that is generated Function by transcapillary filtration and is governed by Starling The lymphatic system is nearly ubiquitous in the human forces, the net difference between hydrostatic and body, present in all tissues except the epidermis, cartil- osmotic pressures, at the microcirculatory level [9]. In age, eye lens, cornea, retina, and bone marrow [1, 2]. order to maintain fluid homeostasis, lymph formation in The main functions of the lymphatic system include the initial lymphatic vessels must be balanced by the net fluid homeostasis and interstitial fluid drainage, immune flux of plasma being filtered out [4].
    [Show full text]
  • Bone Marrow Adipocytes: a Link Between Obesity and Bone Cancer
    cancers Review Bone Marrow Adipocytes: A Link between Obesity and Bone Cancer Michaela R. Reagan 1,2,3,*, Heather Fairfield 1,2,3 and Clifford J. Rosen 1,2,3 1 Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, Maine, ME 04074, USA; [email protected] (H.F.); [email protected] (C.J.R.) 2 School of Medicine, Tufts University, Boston, MA 02111, USA 3 Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME 04469, USA * Correspondence: [email protected]; Tel.: +1-207-396-8196 Simple Summary: This review discusses the important newly-established roles for bone marrow adipose tissue in cancer progression and highlights the research demonstrating great promise for clinically targeting the cells in oncology. Bone marrow adipose tissue expands during aging and in obesity. It primarily comprises bone marrow adipocytes (also known as fat cells) and can also contain other cells, such as pre-adipocytes, fibroblasts, macrophages, other immune cells, and endothelial cells. Bone marrow adipocytes are scattered throughout the hematopoietic or “red” marrow, or are densely packed in the marrow cavity, creating “yellow” marrow. Bone marrow biologists are interrogating many questions to understand the nature of bone marrow adipocytes, including how aging and obesity affect these cells; their origins, functions, and endocrine roles; and whether they can be targeted to treat osteoporosis. In parallel, and often in concert, cancer researchers are delineating the role of bone marrow adipocytes in oncology and their potential translational significance for future therapeutics. Abstract: Cancers that grow in the bone marrow are for most patients scary, painful, and incurable.
    [Show full text]
  • Redalyc.Protective Compromise of Great Omentum in an Asymptomatic
    Revista Colombiana de Ciencias Pecuarias ISSN: 0120-0690 [email protected] Universidad de Antioquia Colombia González-Domínguez, María S; Hernández, Carlos A; Maldonado-Estrada, Juan G Protective compromise of great omentum in an asymptomatic uterine rupture in a bitch: a case report Revista Colombiana de Ciencias Pecuarias, vol. 23, núm. 3, julio-septiembre, 2010, pp. 369-376 Universidad de Antioquia Medellín, Colombia Available in: http://www.redalyc.org/articulo.oa?id=295023477012 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative González-Domínguez MS, et al. Asymptomatic uterine rupture in a bitch 369 Casos clínicos Revista Colombiana de Ciencias Pecuarias http://rccp.udea.edu.co CCP Protective compromise of great omentum in an asymptomatic uterine rupture in a bitch: a case report¤ Compromiso protector del omento mayor en una ruptura uterina asintomática en una perra: reporte de un caso Empenho protetor do omento maior em uma rotura uterina asymptomatica numa cadela: um porte de caso 1* 1 2 María S González-Domínguez , MV, Esp.; Carlos A Hernández , MV, MS; Juan G Maldonado-Estrada , MVZ, MS, PhD. 1Grupo de Investigación INCA-CES Facultad de Medicina Veterinaria y Zootecnia, Universidad CES; Medellín, Colombia. 2Grupo de Investigación CENTAURO, Escuela de Medicina Veterinaria, Universidad de Antioquia. Medellín, Colombia. (Recibido: 19 agosto, 2009; aceptado: 15 julio, 2010 ) Summary The great omentum plays an important role in protecting the peritoneal cavity from bacteria and contaminating material and providing the peritoneum with leukocytes from the omental milky spots (OMS).
    [Show full text]
  • Human and Nonhuman Primate Meninges Harbor Lymphatic Vessels
    SHORT REPORT Human and nonhuman primate meninges harbor lymphatic vessels that can be visualized noninvasively by MRI Martina Absinta1†, Seung-Kwon Ha1†, Govind Nair1, Pascal Sati1, Nicholas J Luciano1, Maryknoll Palisoc2, Antoine Louveau3, Kareem A Zaghloul4, Stefania Pittaluga2, Jonathan Kipnis3, Daniel S Reich1* 1Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, United States; 2Hematopathology Section, Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, United States; 3Center for Brain Immunology and Glia, Department of Neuroscience, School of Medicine, University of Virginia, Charlottesville, United States; 4Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, United States Abstract Here, we report the existence of meningeal lymphatic vessels in human and nonhuman primates (common marmoset monkeys) and the feasibility of noninvasively imaging and mapping them in vivo with high-resolution, clinical MRI. On T2-FLAIR and T1-weighted black-blood imaging, lymphatic vessels enhance with gadobutrol, a gadolinium-based contrast agent with high propensity to extravasate across a permeable capillary endothelial barrier, but not with gadofosveset, a blood-pool contrast agent. The topography of these vessels, running alongside dural venous sinuses, recapitulates the meningeal lymphatic system of rodents. In primates, *For correspondence: meningeal
    [Show full text]
  • New Brain Lymphatic Vessels Drain Old Concepts
    EBioMedicine 2 (2015) 776–777 Contents lists available at ScienceDirect EBioMedicine journal homepage: www.ebiomedicine.com In Focus New Brain Lymphatic Vessels Drain Old Concepts Lasse Dissing-Olesen, Soyon Hong, Beth Stevens⁎ Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA The brain has traditionally been considered an immune privileged vessels above the dcLN completely abolished drainage of dye to these organ, in part due to the lack of evidence for lymphatic vasculature lymph nodes and additionally, increased the diameter of the meningeal (Galea et al., 2007). Two centuries ago, the existence of lymphatic ves- lymphatic vessels, indicating that these vessels drain to the dcLN. The sels on the surface of the human brain was proposed but it has since Alitalo lab further demonstrated that dye injected into the brain paren- been widely dismissed (Lukic et al., 2003). Therefore, while T cells chyma was absorbed by lymphatic vessels and preferentially drained leave all other organs via the lymphatic system to reach nearby lymph into the ipsilateral dcLN from the base of the brain. Surprisingly, Kipnis' nodes, the prevailing view has been that infiltrated T cells exit the lab excluded the best-known route of drainage into the dcLN, via the brain via venous blood circulation, circumventing the lymph nodes nasal cavity's cribriform plate and the nasal mucosa (Kida et al., 1995), (Ransohoff and Engelhardt, 2012). The recent evidence for the existence as they failed
    [Show full text]
  • Extraperitoneal Laparoscopic Resection for Retroperitoneal Lymphatic Cysts
    Wang et al. BMC Urology (2017) 17:101 DOI 10.1186/s12894-017-0288-1 RESEARCHARTICLE Open Access Extraperitoneal laparoscopic resection for retroperitoneal lymphatic cysts: initial experience Yichun Wang1†, Chen Chen1†, Chuanjie Zhang1†, Chao Qin2* and Ninghong Song2* Abstract Background: To assess the safety and efficacy of laparoscopic retroperitoneal resection for retroperitoneal lymphatic cysts. Methods: A retrospective analysis was conducted based on clinical data from eight patients with hydronephrosis caused by retroperitoneal lymphatic cysts. All patients underwent laparoscopic retroperitoneal lymphatic cyst resection and received postoperative follow-up. A follow-up ultrasound was performed postoperatively every 6–12 months to evaluate the recovery of the hydronephrosis. Results: All operations were successful, and their postoperative pathological results revealed lymphatic cyst walls. The operation time ranged from 43 to 88 min (mean: 62 min), with a blood loss of 20 to 130 mL (mean: 76 mL), and the length of hospital stay was 3 to 6 days (mean: 4.5 days). Within the follow-up of 12 to 36 months (mean: 28.5 months), great relief was detected in all eight cases, and no recurrence was found. Moreover, complications such as renal pedicle or renal pelvis injury were not observed. Conclusions: Laparoscopic retroperitoneal lymphatic cyst resection is an effective treatment for retroperitoneal lymphatic cysts and has the advantages of being minimally invasive, producing less intraoperative blood loss and leading to a quick recovery. This treatment thus deserves further studies. Keywords: Hydronephrosis, Lymphatic cyst, Laparoscope Background pain, obstructive uropathy, lower lymphoedema, bowel Lymphatic cysts are a rare lymphatic-vessel-generated obstruction and venous thrombosis [7–10].
    [Show full text]
  • Lateral Peritumoral Lymphatic Vessel Invasion Can Predict Lymph Node Metastasis in Esophageal Squamous Cell Carcinoma
    Modern Pathology (2007) 20, 694–700 & 2007 USCAP, Inc All rights reserved 0893-3952/07 $30.00 www.modernpathology.org Lateral peritumoral lymphatic vessel invasion can predict lymph node metastasis in esophageal squamous cell carcinoma Daisuke Mori1, Fumio Yamasaki1, Masami Shibaki1 and Osamu Tokunaga2 1Division of Pathology, Saga Prefectural Hospital Kouseikan, Saga, Japan and 2Faculty of Medicine, Department of Pathology and Biodefense, Saga University, Saga, Japan Lymph node metastasis is an important prognostic factor in many types of cancer. We investigated the clinical significance of lymphangiogenesis and lymphatic vessel invasion in esophageal squamous cell carcinoma. We evaluated lymphatic vessel density and lymphatic vessel invasion in the intratumoral, peritumoral and normal compartments using D2-40 immunostaining. In addition, the peritumoral compartment was divided into the lateral peritumoral compartment and the non-lateral peritumoral compartment. The lymphatic vessel density was higher in the peritumoral and intratumoral compartments than in the normal compartment. However, the lymphatic vessel density did not correlate with any pathological parameters including lymph node metastasis. Intratumoral and peritumoral lymph vessels were small and collapsed while normal lymphatic vessels and lymphatic vessels with lymphatic vessel invasion were dilated and large. The presence of lymphatic vessel invasion, in the lateral peritumoral compartment but nowhere else, significantly correlated with lymph node metastasis. These results
    [Show full text]
  • Increased Number and Altered Phenotype of Lymphatic Vessels in Peripheral Lung Compartments of Patients with COPD Mori Et Al
    Increased number and altered phenotype of lymphatic vessels in peripheral lung compartments of patients with COPD Mori et al. Mori et al. Respiratory Research 2013, 14:65 http://respiratory-research.com/content/14/1/65 Mori et al. Respiratory Research 2013, 14:65 http://respiratory-research.com/content/14/1/65 RESEARCH Open Access Increased number and altered phenotype of lymphatic vessels in peripheral lung compartments of patients with COPD Michiko Mori1, Cecilia K Andersson2, Gerard J Graham3, Claes-Göran Löfdahl2 and Jonas S Erjefält1,2* Abstract Background: De novo lymphatic vessel formation has recently been observed in lungs of patients with moderate chronic obstructive pulmonary disease (COPD). However, the distribution of lymphatic vessel changes among the anatomical compartments of diseased lungs is unknown. Furthermore, information regarding the nature of lymphatic vessel alterations across different stages of COPD is missing. This study performs a detailed morphometric characterization of lymphatic vessels in major peripheral lung compartments of patients with different severities of COPD and investigates the lymphatic expression of molecules involved in immune cell trafficking. Methods: Peripheral lung resection samples obtained from patients with mild (GOLD stage I), moderate-severe (GOLD stage II-III), and very severe (GOLD stage IV) COPD were investigated for podoplanin-immunopositive lymphatic vessels in distinct peripheral lung compartments: bronchioles, pulmonary blood vessels and alveolar walls. Control subjects with normal lung function were divided into never smokers and smokers. Lymphatics were analysed by multiple morphological parameters, as well as for their expression of CCL21 and the chemokine scavenger receptor D6. Results: The number of lymphatics increased by 133% in the alveolar parenchyma in patients with advanced COPD compared with never-smoking controls (p < 0.05).
    [Show full text]