Angiosarcoma gastrointestinal multifocal, con compromiso extenso de estómago, intestino delgado y colon. Reporte de un caso / Multifocal gastrointestinal angiosarcoma, with extensive gastric, small intestine and colon involvement. A case report

Introducción. El angiosarcoma es una neoplasia vascular originada a nivel del endotelio, de baja frecuencia, conocido por su agresividad y crecimiento acelerado. Alcanza solo el 1 al 2 % del total de los sarcomas. La presentación gastrointestinal es infrecuente y su incidencia es poco conocida debido al escaso reporte de casos en la literatura. Suele identificarse en etapas avanzadas debido a la dificultad del diagnóstico histopatológico por sus características morfológicas, siendo necesario aplicar tinciones especiales o estudio inmunohistoquímico. Caso clínico. Por su interés y singularidad, presentamos el caso de un paciente masculino de 54 años, quien consultó con hemorragia digestiva profusa, anemización y requerimiento de terapia transfusional. Resultados. Durante el proceso diagnóstico, en la endoscopia encontraron diversas lesiones multifocales que se extendían por gran parte del tracto gastrointestinal. El estudio histopatológico mostró angiosarcoma gastrointestinal. Discusión. El angiosarcoma del tracto gastrointestinal es extremadamente infrecuente, de difícil diagnóstico y bajas posibilidades de manejo curativo, con opciones terapéuticas limitadas, lo que configura un mal pronóstico a corto plazo

Introduction. Angiosarcoma is a vascular neoplasm originating from endothelial cells, known for its aggressiveness, accelerated growth and reduced frequency. Reach only 1 to 2% of total sarcomas. Gastrointestinal presentation is extremely rare, the true incidence is poorly known, due to the limited reports of this entity in the literature. It is usually identified in advanced stages in view of the difficulty of the histopathological diagnosis, attributable to its morphological characteristics, being necessary to apply special stains or immunohistochemical study. Case report. Due to their interest and uniqueness, we present the case of a 54-year-old male patient, who presented with a profuse gastrointestinal bleeding, anemia, and requirement for transfusion therapy. Results. The endoscopy detected several multifocal lesions that extended most of the gastrointestinal tract. The histopathological study showed gastrointestinal angiosarcoma. Discussion. Angiosarcoma of the gastrointestinal tract is extremely uncommon, difficult to diagnose and has low possibilities of curative management, with limited therapeutic options, which configures a poor prognosis in the short term

Predictive value of microvessel density and lymphatic vessel density in pancreatic cancer tissue for tumor distant metastasis within 1 year after surgery / 中华胰腺病杂志

Objective:To investigate the value of counting microvessel density (MVD) and lymphatic vessel density (LVD) in predicting distant metastasis of pancreatic cancer within 1 year after surgery.Methods:The clinicopathological data of 47 patients with pancreatic cancer who underwent surgery in Laibin People's Hospital from January 2020 to December 2021 were retrospectively analyzed. The patients were divided into non-metastasis group( n=24) and metastasis group( n=23) according to whether distant metastasis occurred during 1-year follow-up. Immunohistochemistry was used to detect the CD 34 expression in microvascular epithelial cells and D2-40 level in lymphatic epithelial cells from pancreatic cancer tissues. MVD and LVD in cancer tissues and adjacent normal tissues were counted. The relationship between MVD and LVD in cancer tissues and clinicopathological characteristics such as gender, age, tumor diameter, tumor differentiation, lymph node metastasis, vascular invasion, nerve invasion and tumor stage were analyzed. The receiver operating characteristic curve (ROC) was drawn and the area under the curve (AUC) was calculated to evaluate the value of MVD and LVD in predicting distant metastasis of pancreatic cancer within 1 year after surgery. The effects of MVD and LVD on the distant metastasis rate of pancreatic cancer within one year after operation were evaluated. Univariate and multivariate logistic regression were used to analyze the independent influencing factors for distant metastasis of pancreatic cancer within 1 year after surgery. Results:MVD and LVD in metastatic cancer tissues were higher than those in adjacent normal tissues [(72.52±9.73) vs (51.73±7.95)/400 times field of view, (23.78±6.87) vs (14.00±5.66)/400 times field of view]. MVD and LVD in the non-metastasis group were also higher than those in the adjacent normal tissues [(63.20±6.52) vs (54.79±5.80)/400 times field of view, (16.25±5.15) vs (13.62±5.03)/400 times field of view], and all the differences were statistically significant ( P<0.05). MVD in cancer tissue was significantly increased in patients with tumor diameter ≥2 cm, lymph node metastasis, vascular invasion and high TNM stage ( P<0.05), and LVD was significantly increased in patients with tumor diameter ≥2 cm, lymph node metastasis, moderate and low differentiation, vascular invasion, nerve invasion and high TNM stage ( P<0.05). The AUC values of MVD and LVD in predicting distant metastasis of pancreatic cancer within 1 year after surgery were 0.799 (95% CI 0.659-0.939) and 0.803(95% CI 0.676-0.929), and the cut-off values were 70.5 and 20.5/400 times field of view, respectively. The sensitivity was 73.9% and 69.6%, and the specificity was 87.5% and 83.7%. The cumulative distant metastasis rate within 1 year after operation in high MVD and high LVD groups was significantly higher than that in low MVD and low LVD groups ( P<0.05). Multivariate logitic regression analysis showed that tumor diameter ≥2 cm ( OR=1.757, 95% CI 1.536-3.846, P<0.05), lymph node metastasis ( OR=2.364, 95% CI 1.036-4.175, P<0.05), high MVD ( OR=4.345, 95% CI 1.245-3.736, P<0.05) and high LVD ( OR=3.637, 95% CI 1.426-4.035, P<0.05) were independent risk factors for distant metastasis of pancreatic cancer within 1 year after surgery. Conclusions:Increased MVD and LVD in pancreatic cancer tissues are independent influencing factors for distant metastasis within 1 year after surgery, which can be used to predict whether patients have distant metastasis within 1 year after surgery.

Research progress in the effects of ionizing radiation on lymphatic vessels / 中华放射医学与防护杂志

Ionizing radiation can induce the death of lymphatic endothelial cells, leading to structural damage, dysfunction, and reduction of lymphatic vessels, which poses a negative impact on radiotherapy. However, it can also induce tumor cells and tumor-infiltrated immune cells to secrete various cytokines and promote tumor-associated lymphangiogenesis, which favors anti-tumor therapy and improve anti-tumor immunity. Studying the changes in lymphatic vessels after ionizing radiation may be a way to explore the synergistic anti-tumor effects of radiotherapy and immunotherapy. This review summarized the morphological changes in lymphatics after ionizing radiation, the molecular mechanisms for the effects of ionizing radiation on lymphatic vessels, and the clinical value of lymphatic changes after ionizing radiation, aiming to provide ideas for the study of the effects of ionizing radiation on lymphatic vessels.

Linfangioma circunscripto de glande, con resolución quirúrgica / Circumscribed lymphangioma of the glans penis, with surgical resolution

Resumen 22. El linfangioma circunscripto (LC) es una afección rara y benigna, caracterizada principalmente por la malformación de los vasos linfáticos de la piel. De etiología congénita o adquirida,esta última debido a causas secundarias como radioterapia, infecciones o procedimientos quirúrgicos. 23. Presentamos el caso de un paciente de 75 años de edad, con antecedente quirúrgico de fimosis a los 29 años, y posterior desarrollo de linfangioma circunscripto de glande diagnosticado 46 años después. El tratamiento definitivo planteado en interconsulta con Urología fue la resección quirúrgica, motivados por la escasa frecuencia de recidivas cuando se usa este método.

Summary 27. Circumscribed lymphangioma (CL) is a rare and benign condition, characterized mainly by malformation of the lymphatic vessels of the skin. It has a congenital or acquired etiology, the latter due to secondary effects such as radiotherapy, infections or surgical procedures. 28. We present the case of a 75-year-old patient, with a surgical history of phimosis at 29 years of age, and subsequent development of circumscribed lymphangioma of the glans penis diagnosed 46 years later. The definitive treatment proposed in consultation with Urology was surgical resection due to the low frequency of recurrences.

Papillary intralymphatic angioendothelioma: Dabska tumor

Abstract Papillary intralymphatic angioendothelioma (Dabska tumor) is a rarely metastasizing lymphatic vascular neoplasm that usually affects children and young adults. The majority of these cases occur in soft tissues of extremities, and to date less than 40 cases have been described. Despite the generally indolent evolution, can be locally invasive with the potential to metastasize. We describe a case of a young woman presenting with a plantar lesion, for 9 months and histological diagnosis of Dabska tumor. This neoplasm should be considered in the differential diagnosis of vascular dermatoses, allowing early diagnosis and treatment. Long-term follow-up should be performed.

Expression of PD-L1 in triple negative breast cancer tissues and its relationship with angiogenesis / 中国肿瘤生物治疗杂志

@# Objective: To investigate the expressions of programmed death ligand 1（PD-L1）in triple-negative breast cancer (TNBC) and its correlation with angiogenesis. Methods: 120 cases of TNBC patients who underwent surgery in the Fourth Hospital of Hebei Medical University from March 1, 2011 to June 1, 2012 were collected. The tumor tissues of patients were surgically resected and confirmed by pathology. PD-L1 protein expression in TNBC tissues of 120 patients was detected by tissue microarray combined with immunohistochemistry, and its relationship with various clinical indicators was analyzed. Blood vessels and lymphatic vessels were labeled withCD34andD2-40todetectmicrovesseldensity(MVD)andlymphaticvesseldensity(LVD)inTNBC.Results:Thepositiveexpression rate of PD-L1 in the tumor cells and interstitial infiltrating lymphocytes fromTNBC was 56.7% (68/120); No correlation was found between PD-L1 protein expression and the gender, age, histological grade, clinical stage, or tumor size of patients with TNBC (P>0.05), but related to the lymph node metastasis (P<0.05) and vascular thrombus (P<0.05). TNBC with high PD-L1 expression exhibited high incidence of lymph node metastasis and formation of vascular thrombus, and the expression of PD-L1 was positively correlated with MVD (r=0.500, P=0.02) as well as LVD (r=0.662, P=0.01). Log-Rank test showed that the survival time of TNBC patients with positive PD-L1 protein expression was significantly shorter than that of patients with negative expression (P<0.05). Cox multivariate analysis suggested that PD-L1 protein expression could be an independent prognostic factor for TNBC overall survival. Conclusion: PD-L1 plays an important role in TNBC angiogenesis and lymphangiogenesis, and is closely related to TNBC invasion and metastasis; blocking PD1/PD-L1 signal pathway is expected to be an effective new strategy for TNBC treatment.

The preliminary application of 3-dimensional visual technique without eyepiece in repairing breast defect af-ter radical mastectomy in 2 cases of breast cancer / 中华显微外科杂志

To investigate the possibility of microsurgical anastomosis of artery, vein and lymphat-ic vessel under 3-dimension screen without eyepiece. Methods During March, 2019, 2 cases (48 and 62 years old) were operated for breast reconstruction, chest wall deformity modified, and axillary scar contracture release, under 3-dimension screen without eyepiece.Deep epigastric artery perforators (artery and vein) dissections were carried on, and microsurgical anastomosis of artery, vein and lymphatic vessel were finished. Coupler was used to do the end-to-end anastomosis of veins (2.5 mm), interrupted suture end-to-end anastomosis with 9-0 nylon for artery (2.0 mm). Reverse arm lymphatic dynamic fluorescence methylene blue tracer under Near Infrared Imaging was used to test the func-tion of lymphatic system. The ends of 2 dominant drainage lymphatic vessels was found in the released axillary area (0.2 mm and 0.3 mm, respectively), and were anastomosis to the vein (0.5 mm) of lateral chest lymphatic tissue.Im-mediate methylene blue tracer under near infrared imaging was used to confirm the patency of lymphatic vessels-veins anastomosis and follow-up post operation. Flap were monitored use HHD. Results Two patients recovered well, and the flaps survived completely with appreciated appearances. The lymphedema of the arms were getting better, the peripheral diameter was reduced by about 2.0 cm compared with that before operation. Conclusion The technique of microsurgical anastomosis of artery, vein and lymphatic vessel without eyepiece under 3-dimension screen is possi-ble and safe.

The application of Whole-Mount immuno fluorescence staining technique in the study of lymphatic morphology in mice / 中华整形外科杂志

Objective@#To elaborate the characteristics and advantages of Whole-Mount immune fluorescence staining by observing the lymphatic vessels of mice.@*Methods@#The ear skin tissue, the hindlimb lymphatic vessels and the mesenteric lymphatic vessels were harvested from normal C57 mice. The tissue samples were subjected to whole-tissue immunofluorescence staining.These tissue samples were fixed by paraformaldehyde, blocked by bovine serum and incubated in primary and secondary antibodies. Then, the lymphatic vessels were observed and analyzed in these samples with a confocal laser-scanning microscope.@*Results@#The capillary lymphatic vessels and lymphatic endothelial cells can be clearly showed in the ear skin. The valves and smooth muscles can be clearly showed in the hindlimb and mesenteric lymphatic vessels by Whole-Mount immunofluorescence staining.@*Conclusions@#The whole-tissue immunofluorescence staining technique can observe the external morphology of lymphatic vessels clearly and stereoscopically, and can deeply observe the internal structure of lymphatic vessels. This technique can provide more accurate study on physiology and pathology of lymphatic vessels.

Changes of lymphatic vessel density in lung adenocarcinoma in situ, minimally invasive adenocarcinoma, and invasive adenocarcinoma and the regulatory factors / 南方医科大学学报

OBJECTIVE@#To analyze the changes in tumor lymphatic vessel density (LVD) in patients with lung adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and invasive adenocarcinoma (IA) and explore the regulatory factors of LVD.@*METHODS@#Complete clinicopathological data were collected form a total of 301 patients with lung adenocarcinoma, including 28 (9.3%) with AIS, 86 (28.6%) with MIA, and 187 (62.1%) with IA. The LVD of all the adenocarcinomas were calculated after D2-40 immunohistochemical staining, and MT1-MMP and VEGF-C expression levels were also evaluated. The differences in LVD among the groups and the correlations of tumor LVD with the expressions of MT1-MMP and VEGF-C and the clinicopathological factors were analyzed.@*RESULTS@#The LVD differed significantly among AIS, MIA, and IA groups (= 0.000). The LVDs was significantly correlated with the level of VEGF-C protein expression (=0.917, =0.009), tumor size (= 0.686, =0.017), lymph node metastasis (=0.739, =0.000), and clinical stage (=0.874, =0.012) of the patients.@*CONCLUSIONS@#Tumor lymphangiogenesis plays an important role in lung adenocarcinoma progression, and VEGF-C may promote this process.

Advances in lymphatic study of the upper extremity / 中华整形外科杂志

The lymphatic system plays an important role in the humoral circulation, immune activity and cancer metastasis, but the morphological characteristics of this system have to be studied thoroughly in order to adapt to the modern medicine development. Lymphatic vessels are hardly observed in general cadaveric dissection since their channels are tiny and transparent. Therefore, the improvement of the inspection techniques is the key factor for further study of the lymphatic system. In the early stage of lymphatic study, the researchers could only observe the distribution of the lymphatic vessels and nodes of the mesentery, chyle cistern and thoracic duct in postprandial mammals by anatomic dissection, but were unable to investigate the entire system of the body. Great progress in the study has been made with utilizing the direct lymphatic perfusion with mercury as a medium. Then, because of the toxicity of mercury, it was replaced by indirect injection with other instances, like dye, ink, radioisotope etc, which helped achieving rapid progress in the anatomic study and clinical application. The knowledge of the lymphatic system of the body in existing textbooks is largely based on the early anatomical studies, but quite often it does not explain some of the unexpected clinical findings. In early 2000s, a modified method of lymphatic perfusion has been applied for investigating the human lymphatic system. It has been confirmed that there could be significant differences in the lymphatic distribution of individuals. This paper reviews the current investigative approaches of lymphatic distribution of the upper extremity, from a historical perspective.

Diagnóstico y pronóstico prenatal de los linfangiomas fetales. Reporte de dos casos / Diagnosis and prenatal prognosis of fetal lymphangioma. Two cases reports

Resumen ANTECEDENTES: Los linfangiomas fetales son malformaciones del sistema linfático que representan 4% de todos los tumores vasculares en los recién nacidos vivos, con una incidencia de 1.2-2.8‰. CASOS CLÍNICOS: Se comunican dos casos clínicos poco frecuentes, por su localización y extensión, de linfangiomas fetales. En ambas pacientes el diagnóstico se estableció mediante estudio ecográfico, durante el tercer trimestre, en gestaciones de bajo riesgo. La alteración no se relacionó con malformaciones estructurales adicionales, trastornos cromosómicos ni genéticos. La resonancia magnética confirmó el diagnóstico de la enfermedad. En una de las madres, el tamaño del feto determinó la vía de finalización del embarazo (parto). La cirugía fue el tratamiento de elección, con evolución satisfactoria en una paciente y la otra permanece a la espera de una nueva intervención quirúrgica, pues aún manifiesta recidivas. En la actualidad, el desarrollo psicomotor, ponderal y estructural de las pacientes es adecuado. CONCLUSIÓN: La ecografía es un estudio decisivo para establecer el diagnóstico y seguimiento de los linfangiomas fetales.

Abstract BACKGROND: Fetal lymphangiomas are malformations of the lymphatic system, representing 4% of all vascular tumors in living newborns, with an incidence of 1.2-2.8‰. CLINICAL CASE: Two uncommon clinical cases, due to their location and extension, of fetal lymphangiomas are reported. In both patients, the diagnosis was established by ultrasound study, during the third trimester, in low risk gestations. The alteration was not related to additional structural malformations, chromosomal or genetic disorders. Magnetic resonance confirmed the diagnosis of the disease. In one mothers, the size of the fetus determined the route of termination of pregnancy (delivery). Surgery was the treatment of choice, with satisfactory evolution in one patient and the other remains awaiting a new surgical intervention, because it still manifests recurrences. At present, the psychomotor, weigth and size development of the patients is adequate. CONCLUSION: Ultrasound is critical for diagnosis and monitoring of this type of malformations.

Relationship between CD44v6 ,ICAM-1 and lymph node metastasis in early stage of cervical squamous cell carcinoma / 重庆医学

Objective To investigate the relationship between adhesion molecule CD44v6,intercellular adhesion molecule-1 (ICAM-1) and lymph node metastasis in early stage of cervical squamous cell carcinoma.Methods Seventy-four specimens of cervical cancer stage Ⅰ b1,20 specimens of normal cervical tissue and 20 specimens of cervical squamous cell in situ carcinoma were collected from Jiangxi Provincial Maternal and Child Health Care Hospital.The expression of CD44v6 and ICAM-1 in cervical tissue was detected by real-time PCR and immunohistochemistry.The lymphatic vessel density (LVD) labeled by D2-40 was detected by immunohistochemistry.The relationship of CD44v6,ICAM-1 and LVD with the differentiation degree and lymph mode metastasis was investigated.Results The positive expression rate of CD44v6 and ICAM-1 in normal cervix,cervical squamous cell carcinoma in situ,and cervical carcinoma tissues was gradually increased,which were 0,75.00％,87.84％ and 10.00％,45.00％,81.08％ respectively.Their mRNA expression amount was gradually increased,which were 0,0.24±0.02,1.02±0.11 and 0.10 ± 0.00,0.19±0.02,1.03 ± 0.10 respectively,the differences were statistically significant (P＜0.01).LVD was gradually increased in normal cervix,cervical squamous cell carcinoma in situ,and cervical carcinoma (P＜0.01).The expression of CD44v6,ICAM-1 and LVD in low differentiated cervical carcinoma tissue was higher than that in high and middle differentiated cervical carcinoma (P＜0.01).The expression of CD44v6,ICAM-1and LVD in lymph node metastasis was higher than that in non-lymph node metastasis (P＜0.01).The expression of CD44v6,ICAM-1 and LVD in cervical cancer tissue had each two positive correlation (P＜0.01).Conclusion CD44v6 plays a promoting role in the progression of cervical cancer,which with ICAM-1 and LVD synergically promote the cervical cancer development,and could be used as an effective indicator for judging lymph node metastasis and diagnosis of cervical cancer.

Clinical application of cocktail double enzyme labeled antibody(D2-40/CK19)staining for the diagnosis of lymphatic vessel invasion in papillary thyroid carcinoma / 中华内分泌代谢杂志

Objective To analyse the relationship between lymphatic vessels invasion and clinical pathological features of papillary thyroid carcinoma ( PTC ) .Methods The expressions of D2-40 and CK19 were examined in the 104 specimens of PTC using immunohistochemical staining with combined monoclonal antibodies and cocktail double enzyme labeled antibody( D2-40/CK19) stainings.The two methods were compared in the diagnosis of PTC metastasis, and the factors affecting lymphatic vessels formation were analyzed.Results The positive rate of lymphatic vessels invasion was 37.5%(39/104) by using immunohistochemical staining with combined monoclonal antibodies and 53.8%( 56/104 ) by cocktail double enzyme labeled antibody ( D2-40/CK19 ) staining ( P<0.05).The lymph node metastasis rate was 83.9%(47/56) in the group with lymphatic vessels invasion, significantly higher than that without invasion 22.9%(11/48, P<0.01).The age of patients, diameter of primary tumor were the influence factors of lymphatic vessels invasion in PTC patients(P<0.05 and P=0.063).Conclusion Cocktail double enzyme labeled antibody ( D2-40/CK19 ) staining is a better method to detect lymphatic vessels invasion in PTC than immunohistochemical staining with combined monoclonal antibodies.

Lymphangiogenesis and lymphatic vessel remodelling in cancer / 医学研究生学报

It is well known that the tumor mainly transfers through the lymphatic vessels of the tumor .The current studies main-ly focus on the mechanism of metastasis , hoping to uncover the lymph node metastasis through investigating generation of lymphatic ves -sels and remodeling of tumor lymphatic vessels .Lymph node metastasis is directly related to and prognosis and the quality of life of cancer patients , and how to block the corresponding signaling pathways to prevent tumor lymphangiogenesis becomes the research fo -cus.This paper reviews the lymphangiogenesis and lymphatic vessel remodeling .

Correlation between MSCT features and expression of VEGF-C,lymphatic vessel density in gastric carcinoma / 实用放射学杂志

Objective To evaluated the correlations between MSCT features and expression of VEGF-C,lymphatic vessel density (LVD)in gastric carcinoma.Methods Both plain MSCT and triphasic dynamic contrast-enhanced scan were performed in 58 patients with gastric carcinoma.All patients underwent total/subtotal gastrectomy after MSCT scanning.All specimens were collected into liquid nitrogen or deep freeze refrigerator.Detection procedure for VEGF-C mRNA was performed using RT-PCR,and the LVD was detected with 5’-nucleotidase (5’-Nase)histochemistry.Results The VEGF-C positive rate and the LVD in tumor tissue were high-er than those in normal tissue (P < 0.05 ).In the tumors between diffused and intestinal groups and between non-metastasis and lymph node metastasis groups,the VEGF-C positive rate was 87.1% and 59.3%,87.8% and 41.2%,and the LVD was 8.04±4.58 and 4.08±2.44,8.50±4.70 and 3.64 ± 1.41,respectively,indicating statistically significant differences (P <0.05 ).Conclusion Over-expression of VEGF-C and higher LVD are closely correlated with the lymph node metastasis and Lauren types of MSCT fea-tures of gastric carcinoma.VEGF-C can promote the lymphangiogenesis in carcinoma and further lymph metastasis.

Malformación linfática facial mixta: Caso clínico / Mixed facial lymphatic malformation: Case report

Lymphangiomas are a common form of vascular malformation of the lymphatic vessels, mainly in the head and neck region. Most cases are progressive evolution and require a multidisciplinary approach. Currently, the first therapeutic option is sclerotherapy, leaving surgery for the treatment of remaining lesions. Objective: To present a case of facial lymphatic malformation (LM) treated with sclerotherapy, surgery and orthodontics in a 15-year follow up. Case report: A one-year-old female patient who consulted health professionals due to a progressive volume increase of the soft parts of her right cheek. The imaging study confirmed the diagnosis of microcystic lymphatic malformation. It was managed with OK-432 sclerotherapy and Bleomycin. At 2 years of age, the patient response was considered adequate; an intralesional submandibular surgical excision was then performed, with partial resection of the lesion. The biopsy confirmed the diagnosis of microcystic LM. Six months after, a re-resection was planned using the same approach and removing the remaining lesion, with favorable development until the age of 9 years when the patient required surgery and orthodontic management due to intraoral recurrence. No major developments until the age of 13 when a new orthodontic surgery and handling are planned to perform right oral commissure suspension. Conclusion: LM management by sclerotherapy, surgery, and orthodontics has shown the advantages of a multidisciplinary long-term treatment in this case.

El linfangioma corresponde a una malformación vascular de los vasos linfáticos, preferentemente de la región de cabeza y cuello. La mayoría de los casos son de evolución progresiva y requieren un manejo multidisciplinario. Actualmente la primera opción terapéutica es la esclerosis, reservando la cirugía para el tratamiento de las lesiones remanentes. Objetivo: Presentar un caso de malformación linfática (ML) facial, tratado con escleroterapia, cirugía y ortodoncia en un seguimiento a 15 años. Caso clínico: Paciente de sexo femenino que consulta al año de edad por aumento de volumen progresivo de partes blandas en su mejilla derecha. El estudio de imágenes confirmó el diagnóstico de Malformación Linfática microquística. Se manejó con esclerosis seriada con OK-432 y Bleomicina. A los 2 años de edad se consideró que la respuesta era adecuada, y se procedió a realizar extirpación quirúrgica intralesional submandibular, con resección parcial de la lesión. La biopsia confirmó el diagnóstico de ML microquística. Seis meses después se planificó nueva resección utilizando el mismo abordaje y extirpando lesión remanente, con evolución favorable hasta la edad de 9 años en que requiere cirugía y manejo por ortodoncia, por recidiva de lesión a nivel intraoral. Evolución favorable hasta que a la edad de 13 años se planifica nueva cirugía y manejo por ortodoncia para suspender la comisura bucal derecha. Conclusión: El manejo de la ML mediante escleroterapia, cirugía, y ortodoncia muestra en este caso las ventajas de un tratamiento multidisciplinarion a largo plazo.

Metastasis via Peritumoral Lymphatic Dilation in Oral Squamous Cell Carcinoma / 대한악안면성형재건외과학회지

PURPOSE: Nodal metastasis is the main prognostic factor in the patients with oral squamous cell carcinoma (OSCC). We investigated the association between tumor-associated lymphatics and OSCC characteristics. METHODS: Thirty-four specimens were used for the immunohistochemical staining with the antibody for vascular endothelial growth factor (VEGF)-C, VEGF-D, VEGF receptor (VEGFR)-3, phosphorylated VEGFR-3, D2-40, and matrix metallproteinases (MMPs). We observed the distribution of the lymphangiogenic factors and quantified the degree of expression. We determined lymphatic vessel density (LVD) and lymphatic vessel dilatation with D2-40 immunostaining. We assessed the association of LVD or lymphatic vessel dilatation with tumor progression or tumor differentiation. RESULTS: OSCC cells expressed lymphangiogenic ligands. Lymphangiogenic receptor, VEGFR-3, was expressed and activated in some tumor cells as well as in tumor-associated endothelial cells. LVD was not associated with tumor size or nodal status, but lymphatic vessel dilatation was higher in tumors with nodal metastasis, and also higher in poorly differentiated tumors. In stromal area of OSCC, MMP-1 and MMP-10 were up-regulated and the basement membrane of tumor-associated endothelial cells was destroyed by these collagenases. CONCLUSION: In the primary tumors with nodal metastasis, especially in poorly differentiated OSCC, tumor cells invaded the dilated lymphatic vessels via ruptured sites. MMP-1 and MMP-10 are important in the lysis of the glycocalyx inside the tumor-associated lymphatic endothelial cells.

Research advances in corneal newborn lymphatic vessel and corneal transplantation rejection / 国际眼科杂志(Guoji Yanke Zazhi)

Corneal newborn lymphatic vessels construct the afferent arc of corneal immunological reaction, which play important role in immune response. The corneal transplantation rejection rate rises due to the emergence of new lymphatic vessel which breaks the immunologic mechanism. With the founding of specific marker of lymphatic endothelial cells and research advancing of growth factor of lymphatic vessels, the mechanism, therapy and prevention of corneal immunological rejection reaction of corneal lymphatic vessel have been studied intensively. The graft survival rate has been greatly improved through inhibiting newborn lymphatic vessel.

Correlation of lymphatic vessel density with a high mobility group Box-1 protein and tumor-associated macrophages in cervical carci-noma / 中国肿瘤临床

Objective: To detect the correlation of lymphatic vessel density (LVD) with a high mobility group box-1 Protein (HMGB1) and tumor-associated macrophages (TAMs) in cervical carcinoma and the effect on prognosis. Methods:Immunohistochem-istry was applied to detect HMGB1, CD68, and D2-40 expressions in cervical squamous cell carcinoma in 93 cases. t test,χ2 test, Spear-man rank correlation analysis, Kaplan-Meier method, and Cox regression were performed to analyze the expression levels, correlation, and prognosis. Results: HMGB1 protein, CD68, and D2-40 were highly expressed in CSCC. As HMGB1 and TAM expressions in-creased, lymphatic vessel density increased. As HMGB1 and TAM expressions decreased, lymphatic vessel density decreased. Positive correlations were also found between the HMGB1 protein, TAM content, and LVD. In the group with low HMGB1 and TAM expres-sions, the survival time of the group with a high LVD expression was significantly lower than that of the group with a low LVD expres-sion. A multivariate Cox regression model showed that HMGB1 and lymph node metastasis were independent prognostic factors. TAMs and LVD were not independent prognostic factors. Conclusion:HMGB1 proteins and TAMs were highly expressed in CSCC. Patients who exhibit increased HMGB1 expression or increased TAM count consequently show enhanced LVD expressions, increased lymph node metastasis, and poor prognosis.

Research progress of axillary reverse mapping:A new technique to minimize arm lymphedema after breast cancer surgery / 中国肿瘤临床

Axillary reverse mapping (ARM) is a technique used to map and preserve arm lymphatic drainage during axillary lymph node dissection (ALND) and/or sentinel lymph node dissection (SLND). As a result, the risk of arm lymphedema is reduced. ARM is an emerging technology for breast cancer surgery and currently in the clinical trial phase. In this article, related clinical trials conducted in recent years were reviewed and the displaying methods of ARM lymph nodes and lymphatic vessels were analyzed. The feasibility of retained ARM lymph nodes and lymphatic vessels was also evaluated. Furthermore, the clinical significance of ARM was evaluated in terms of the reduction of the incidence of upper extremity lymphedema after breast cancer surgery.