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1.
Chinese Journal of Oncology ; (12): 430-435, 2022.
Article in Chinese | WPRIM | ID: wpr-935232

ABSTRACT

Objective: To evaluate the feasibility of identification and preservation of arm lymphatics (DEPART) in axillary lymph node dissection (ALND) for breast cancer to prevent arm lymphedema. Methods: A randomized controlled study method was used. Two hundred and sixty-five patients who underwent breast cancer surgery at the Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University from November 2017 to June 2018 were included, and the patients were randomly divided into ALND+ DEPART group (132 patients) and standard ALND group (133 patients) by random number table method. In the ALND+ DEPART group, indocyanine green and methylene blue were injected as tracers before surgery, and the arm sentinel nodes was visualized by staged tracing during intraoperative dissection of axillary lymph nodes. Partial frozen sections were made of arm lymph nodes >1 cm in length and hard and suspicious of metastasis, and arm lymph nodes and lymphatic vessels were selectively preserved. Patients in the standard ALND group underwent standard ALND. Objective and subjective indexes of arm lymphedema were evaluated by 5-point circumference measurement and Norman questionnaire. Results: Among 132 breast cancer patients in the ALND+ DEPART group, 121 (91.7%) completed DEPART. There were no statistically significant differences in age, body mass index, pathological type, dissection number of axillary lymph node, N stage, TNM stage, molecular typing, and regional radiotherapy between the ALND+ DEPART and standard ALND groups (P>0.05). At a median follow-up of 24 months, assessment by the 5-point circumference measurement showed that the incidence rates of lymphedema in the ALND+ DEPART and standard ALND groups were 5.0% (6/121) and 15.8% (21/133), respectively, with statistically significant differences (P=0.005). Assessment by the Norman questionnaire showed that the incidence rates of lymphedema in the ALND+ DEPART and standard ALND groups were 5.8% (7/121) and 21.8% (29/133), respectively, with a statistically significant difference (P<0.001). No local regional recurrence was observed in either group during the follow-up period. Conclusion: For breast cancer patients with positive axillary lymph nodes, the administration of DEPART during ALND can reduce or avoid the occurrence of arm lymphedema without compromising oncology safety.


Subject(s)
Arm/pathology , Axilla/pathology , Breast Neoplasms/pathology , Female , Humans , Lymph Node Excision/methods , Lymph Nodes/surgery , Lymphatic Vessels/pathology , Lymphedema/surgery , Sentinel Lymph Node Biopsy/adverse effects
2.
Arq. bras. oftalmol ; 84(3): 209-213, May-June 2021. graf
Article in English | LILACS | ID: biblio-1248967

ABSTRACT

ABSTRACT Purpose: To identify the lymphatic vessels in orbital specimens from human cadavers using light microscopy and immunohistochemical analysis. Methods: A postmortem study included 10 orbital specimens from 10 human cadavers. The orbital specimens were obtained no later than 12 hours after death. The orbital specimens were dissected into lacrimal gland, optic nerve, fat tissue, and oculomotor muscles. The histologic criteria to qualify as a lymphatic vessel were thin-walled channels of endothelium without a well-developed basal membrane and with an erythrocyte-free, irregular lumen. The immunohistochemical criteria were irregularly shaped, thin-walled vessels with an erythrocyte-free, irregular lumen and immunopositivity for podoplanin D2-40. Results: The lacrimal gland, optic nerve, fat tissue, and extraocular muscle sections were positively stained with podoplanin D2-40. Conclusions: This study demonstrated lymphatic vessels in the human orbit, more precisely, in the lacrimal gland, dura mater of the optic nerve, adipose tissue, and extrinsic oculomotor muscles via light microscopy and immunohistochemistry.(AU)


RESUMO Objetivos: Identificar vasos linfáticos em espécimes orbitários de cadáveres humanos através de microscopia óptica e análise imunohistoquímica. Métodos: Um estudo postmortem incluiu dez espécimes orbitários provenientes de dez cadáveres humanos. Todos os espécimes orbitários foram obtidos até 12 horas após a morte com uma técnica cirúrgica de exenteração orbitária e dissecados em glândula lacrimal, nervo óptico, gordura órbitária e músculos extraoculares. Para classificar como um vaso linfático, os critérios histológicos incluíram vasos endoteliais de parede única sem membrana basal bem desenvolvida, irregulares e lúmen sem hemácias, e os critérios imunohistoquímicos incluíram vasos endoteliais de parede única, com formato irregular e lúmen sem hemácias e reagentes a podoplanina D2-40. Resultados: As lâminas histológicas de glândula lacrimal, nervo óptico, tecido adiposo e músculos extraoculares reagiram positivamente a podoplanina D2-40. Conclusão: Este estudo demonstrou vasos linfáticos na órbita humana, mais exatamente, na glândula lacrimal, no nervo óptico, na gordura orbitária e nos músculos extrínsecos extraoculares via microscopia óptica e imunohistoquímica.(AU)


Subject(s)
Optic Nerve/anatomy & histology , Orbit/anatomy & histology , Lymphatic Vessels/diagnostic imaging , Immunohistochemistry , Lacrimal Apparatus/anatomy & histology , Microscopy/instrumentation , Oculomotor Muscles/anatomy & histology
3.
J. vasc. bras ; 20: e20200160, 2021. graf
Article in Portuguese | LILACS | ID: biblio-1279364

ABSTRACT

Resumo A linfangiectasia intestinal consiste em um grupo de doenças raras caracterizadas pela dilatação dos canais linfáticos. A fisiopatologia compreende a obstrução da drenagem linfática do intestino delgado com dilatação secundária dos vasos linfáticos mucosos, submucosos ou subserosos, que distorcem a arquitetura das vilosidades e conduzem à perda de linfa para a luz intestinal, levando à má absorção. Os vasos linfáticos afetados localizam-se primariamente no intestino delgado, que é atingido em extensão variável. A sua etiologia é ainda desconhecida. O relato a seguir apresenta um raro caso de linfangiectasia intestinal em paciente adulto.


Abstract Intestinal lymphangiectasia is a group of rare diseases characterized by dilation of lymphatic channels. Its pathophysiology comprises obstruction of small bowel lymphatic drainage with secondary dilation of mucosal, submucosal, or subserous lymphatic vessels, distorting villous architecture and causing loss of lymph into the intestinal lumen, leading to malabsorption. The affected lymphatic vessels are primarily located in the small intestine, which is affected to a varying extent. Its etiology is still unknown. The following report presents a rare case of intestinal lymphangiectasia in an adult patient.


Subject(s)
Humans , Male , Middle Aged , Lymphatic Vessels/physiopathology , Intestine, Small/physiopathology , Lymphangiectasis, Intestinal/physiopathology , Rare Diseases , Lymphangiectasis, Intestinal/diagnosis , Lymphangiectasis, Intestinal/diet therapy
4.
Chinese Journal of Lung Cancer ; (12): 874-880, 2021.
Article in Chinese | WPRIM | ID: wpr-922140

ABSTRACT

Lung cancer ranks the first cancer-related morbidity and mortality in China. Tumor metastasis always predicts the poor prognosis for patients. Moreover, lymphatic metastasis is one of the most significant predictors of poor prognosis in patients with non-small cell lung cancer (NSCLC) and lymphangiogenesis represents the bridge that functionally facilitates tumor lymphatic metastasis. In this review, we first discussed the molecular mechanisms of tumor-associated lymphangiogenesis and the interaction between tumor microenvironment and lymphatic endothelial cells, then, summarized the role of non-coding RNA in regulating tumor-associated lymphangiogenesis in recent frontier studies, with the aim to provide some novel insights on NSCLC-related lymphangiogenesis research, diagnosis and treatment.
.


Subject(s)
Carcinoma, Non-Small-Cell Lung/genetics , Disease Progression , Endothelial Cells , Humans , Lung Neoplasms/genetics , Lymphangiogenesis , Lymphatic Metastasis , Lymphatic Vessels , Tumor Microenvironment , Vascular Endothelial Growth Factor C
5.
J. vasc. bras ; 19: e20190139, 2020. graf
Article in Portuguese | LILACS | ID: biblio-1143213

ABSTRACT

Resumo Contexto O edema de membros inferiores (MMII) possui causas de origem sistêmicas e locais. Uma inovação é a utilização de um software de caracterização tecidual para diferenciação da origem do edema em imagens de ultrassom. Objetivos Determinar os parâmetros do uso de software na imagem ultrassonográfica para diferenciação de edema de origem venosa e/ou linfática em MMII. Métodos Trata-se de um estudo transversal do tipo quantitativo analítico com amostragem não probabilística por conveniência. Os instrumentos de coleta foram: anamnese, exame físico, exame de ultrassom e análise do software de caracterização tecidual por imagem ultrassonográfica por meio da quantificação da ecogenicidade e da mediana da escala de cinza (GSM). Resultados A amostra foi composta por 42 MMII de edema venoso, 35 de edema linfático, 14 de edema misto e 11 controle. Quanto à distribuição dos pixels nos intervalos de ecogenicidade, o grupo com edema venoso apresentou 88,31% entre o intervalo hipoecogênico IV ao ecogênico III; o grupo com edema linfático, 71,73% entre o intervalo hipoecogênico II ao ecogênico I; grupo com edema misto, 76,17% entre o intervalo hipoecogênico III ao ecogênico II; e o grupo controle, 84,87% entre o intervalo ecogênico II ao hiperecogênico I. A média e o desvio-padrão da GSM apresentaram diferença estatística entre os grupos. Conclusão O software CATUS permitiu a diferenciação do tipo de edema de MMII, facilitando o diagnóstico do tipo de edema e, consequentemente, a escolha da melhor opção terapêutica.


Abstract Background Lower limb edema has both systemic and local causes. Using software to differentiate the origin of edema in ultrasound images is an innovation. Objective To determine the parameters for using software to differentiate edema of venous and/or lymphatic origin in ultrasound images of the lower limbs. Method This is a cross-sectional, quantitative, analytical study with non-probabilistic sampling by convenience. Data were collected by patient interview, physical examination, ultrasound examination, and analysis of software for tissue characterization in ultrasound image by means of quantification of echogenicity and Gray Scale Median (GSM). Results The sample comprised 42 lower limbs with venous edema, 35 with lymphatic edema, 14 with mixed edema, and 11 control limbs. The distributions of pixels in echogenicity intervals by group was as follows. In the venous edema group, 88.31% were distributed from hypoechogenic interval IV to echogenic interval III; in the lymphatic edema group 71.73% were from hypoechogenic interval II to echogenic interval I; in the mixed edema group 76.17% were from hypoechogenic interval III to echogenic interval II; and in the control group 84.87% were distributed from echogenic interval II to hyperechogenic interval I. Mean and standard deviation of GSM values showed statistical differences between groups. Conclusion The CATUS software enabled differentiation of the type of lower limb edema, facilitating diagnosis of edema type and, consequently, choice of the best therapeutic option.


Subject(s)
Humans , Male , Female , Ultrasonography/instrumentation , Edema/diagnostic imaging , Venous Insufficiency/diagnostic imaging , Software , Cross-Sectional Studies , Ultrasonography/methods , Lower Extremity , Lymphatic Vessels , Diagnosis, Differential , Analytical Epidemiology
6.
J. vasc. bras ; 19: e20190112, 2020. graf
Article in Portuguese | LILACS | ID: biblio-1056670

ABSTRACT

Resumo A formação de linfocele, resultante da transecção dos canais linfáticos durante procedimentos cirúrgicos ou traumas, é relativamente comum, sendo relatada em aproximadamente 30% dos pós-operatórios de ressecção de linfonodos. Ela pode evoluir assintomática ou pode apresentar complicações, como dor, infecção secundária, compressão de vasos sanguíneos, a qual evolui para estase, trombose e edema. Seu tratamento ainda é de difícil consenso. Este artigo propõe descrever três casos em que o tratamento foi realizado a partir de ecoescleroterapia com polidocanol. Sua relevância está na escassez de relatos na literatura.


Abstract Formation of lymphocele secondary to transection of lymphatic channels during surgical procedures or traumas is relatively common and is reported in the postoperative period of approximately 30% of lymph node resection procedures. The condition may be asymptomatic or can present with complications such as pain, secondary infection, and compression of blood vessels, which can cause stasis, thrombosis, and edema. There is no consensus on treatment. This article describes three cases in which treatment was provided using polidocanol echosclerotherapy. Its relevance lies in the scarcity of reports in the literature.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged, 80 and over , Lymphocele/therapy , Sclerotherapy/methods , Polidocanol/therapeutic use , Postoperative Period , Sclerotherapy/instrumentation , Lymphatic Vessels/injuries , Edema
7.
Acta cir. bras ; 34(9): e201900903, 2019. tab, graf
Article in English | LILACS | ID: biblio-1054692

ABSTRACT

Abstract Purpose: To investigate the effect of mesenteric lymph drainage on the spleen injury and the expressions of inflammatory cytokines in splenic tissue in mice following hemorrhagic shock. Methods: Male C57 mice were randomly divided into the sham shock, shock and shock+drainage groups. The mice in both shock and shock+drainage groups suffered femoral artery bleeding, maintained mean arterial pressure (MAP) of 40±2 mmHg for 90 min, and were resuscitated. And mesenteric lymph drainage was performed in the shock+drainage group at the time of resuscitation. After three hours of resuscitation, the splenic tissues were harvested for the histological observation and protein and mRNA expression analysis of cytokines. Results: The spleen in the shock group revealed a significantly structural damage and increased mRNA expressions of MyD88 and TRAF6 and protein expressions of TIPE2, MyD88, TRIF and TRAF3 compared to the sham group. By contrast, the splenic pathological injury in the shock+drainage group was alleviated significantly, and the mRNA and protein expressions of TIPE2, MyD88, TRIF, TRAF3 and TRAF6 were significantly lower than those in the shock group. Conclusion: These results indicate that post-hemorrhagic shock mesenteric lymph drainage alleviates hemorrhagic shock-induced spleen injury and the expressions of inflammatory cytokines.


Subject(s)
Animals , Male , Rats , Shock, Hemorrhagic/complications , Spleen/injuries , Lymphatic Vessels/surgery , Inflammation/prevention & control , Mesentery , Resuscitation , Drainage/methods , Disease Models, Animal , Inflammation/etiology , Mice, Inbred C57BL
8.
Article in English | WPRIM | ID: wpr-763146

ABSTRACT

PURPOSE: The purpose of this study was to detect the lymphatic drainage pattern of internal mammary area and verify the concept of internal mammary sentinel lymph node (IM-SLN) in breast. MATERIALS AND METHODS: A small particle radiotracer ((99m)Tc-Dextran 40) was prepared and tested. (99m)Tc-Dextran 40 was injected into intraparenchyma at the sound breast by a modified radiotracer injection technique. Subsequently, dynamic single-photon emission computed tomography (SPECT), computed tomography (CT), and SPECT/CT combination images were performed to identify the radioactive lymph vessels and internal mammary lymph nodes (IMLNs). The direction of lymph drainage and the location of the IMLNs were identified in the SPECT/CT imaging. RESULTS: The radiochemical purity of (99m)Tc-Dextran 40 was > 95%. (99m)Tc-Dextran 40 could drainage into first, second, and third lymph node and the radioactive lymph node could be detected by the γ detector in the animal experiment. After (99m)Tc-Dextran 40 injecting into intraparenchyma, 50.0% cases (15/30) were identified the drainage lymphatic vessels and radioactive IMLNs by SPECT. The drainage lymphatic vessel was found from injection point to the first IMLN (IM-SLN) after 10.5±0.35 minutes radiotracer injection, and then (99m)Tc-Dextran 40 was accumulated into the IM-SLN. The combination imaging of SPECT/CT showed the second IMLN received the lymph drainage from the IM-SLN. The lymphatic drainage was step by step in the internal mammary area. CONCLUSION: The lymph was identified to drain from different regions of the breast to IM-SLN, and then outward from IM-SLN to other IMLN consecutively. It demonstrated the concept of the IM-SLN and provided more evidences for the application of internal mammary sentinel lymph node biopsy.


Subject(s)
Animal Experimentation , Breast Neoplasms , Breast , Drainage , Lymph Nodes , Lymphatic Vessels , Sentinel Lymph Node Biopsy , Tomography, Emission-Computed , Tomography, Emission-Computed, Single-Photon
9.
Article in English | WPRIM | ID: wpr-762844

ABSTRACT

BACKGROUND: Lymphaticovenous anastomosis is an important surgical treatment for lymphedema, with lymphaticovenous side-to-end anastomosis (LVSEA) and lymphaticovenous end-to-end anastomosis being the most frequently performed procedures. However, LVSEA can cause lymphatic flow obstruction because of regurgitation and tension in the anastomosis. In this study, we introduce a novel and simple procedure to overcome this problem. METHODS: Thirty-five female patients with lower extremity lymphedema who underwent lymphaticovenous anastomosis at our hospital were included in this study. Eighty-five LVSEA procedures were performed, of which 12 resulted in insufficient venous blood flow. For these 12 anastomoses, the proximal lymphatic vessel underwent clipping after the anastomotic procedure and the venous inflow was monitored. Subsequently, the proximal ligation after side-to-end anastomosis recovery (PLASTER) technique, which involves ligating the proximal side of the lymphatic vessel, was applied. A postoperative evaluation was performed using indocyanine green 6 months after surgery. RESULTS: Despite the clipping procedure, three of the 12 anastomoses still showed poor venous inflow. Therefore, it was not possible to apply the PLASTER technique in those cases. Among the nine remaining anastomoses in which the PLASTER technique was applied, three (33%) were patent. CONCLUSIONS: Our findings show that achieving patent anastomosis is challenging when postoperative venous inflow is poor. We achieved good results by performing proximal ligation after LVSEA. Thus, the PLASTER technique is a particularly useful recovery technique when LVSEA does not result in good run-off.


Subject(s)
Edema , Female , Humans , Indocyanine Green , Ligation , Lower Extremity , Lymphatic Diseases , Lymphatic Vessels , Lymphedema , Microsurgery
10.
Rev. chil. cir ; 70(6): 589-597, dic. 2018. tab, ilus
Article in Spanish | LILACS | ID: biblio-978034

ABSTRACT

El linfedema es la acumulación de fluido rico en proteínas en el intersticio, secundario a anomalías en el sistema de transporte linfático. En países desarrollados se relaciona más frecuentemente al tratamiento quirúrgico del cáncer. El diagnóstico clínico y a través de técnicas de imágenes es fundamental para evaluar el estado funcional del sistema linfático. Los objetivos principales en el manejo del linfedema son limitar la morbilidad del paciente, mejorar la funcionalidad y la calidad de vida. El tratamiento quirúrgico es una alternativa cuando las medidas conservadoras ya no son suficientes. Existen procedimientos que buscan prevenir el desarrollo del linfedema y técnicas que incluye procedimientos fisiológicos (reconstructivos) y resectivos que se utilizan cuando el linfedema ya está establecido. El éxito depende de una buena elección de los pacientes y la realización de un tratamiento individualizado. A continuación se presenta una revisión en cuanto a las últimas estrategias diagnósticas y actualización en las técnicas quirúrgicas con énfasis en el tratamiento microquirúrgico.


Lymphedema is the accumulation of protein-rich fluid in the interstitium, secondary to abnormalities in the lymphatic transport system. In developed countries it is more often related to surgical treatment of cancer. The clinical diagnosis and through imaging techniques is fundamental to evaluate the functional status of the lymphatic system. The main objectives in managing lymphedema are to limit patient morbidity, improve functionality and quality of life. Surgical treatment is an option when conservative measures are no longer sufficient. There are procedures that seek to prevent the development of lymphedema, and techniques that include physiological (reconstructive) and resective procedures that are used when lymphedema is already established. Success depends on a good selection of patients and the completion of an individualized treatment. The following is a review article of the latest diagnostic strategies and update in surgical techniques with emphasis on microsurgical treatment.


Subject(s)
Humans , Lymphedema/surgery , Lymphedema/diagnostic imaging , Veins/surgery , Anastomosis, Surgical , Magnetic Resonance Imaging , Lymphography , Contrast Media , Lymphatic Vessels/surgery , Lymphoscintigraphy , Indocyanine Green , Lymph Nodes/blood supply , Lymph Nodes/transplantation , Lymphedema/therapy , Microsurgery
11.
Article in Chinese | WPRIM | ID: wpr-771469

ABSTRACT

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.


Subject(s)
Adenocarcinoma , Chemistry , Pathology , Adenocarcinoma of Lung , Chemistry , Pathology , Humans , Immunohistochemistry , Lymphangiogenesis , Lymphatic Vessels , Chemistry , Pathology , Neoplasm Staging , Prognosis , Tumor Burden , Vascular Endothelial Growth Factor C
12.
Anatomy & Cell Biology ; : 150-157, 2018.
Article in English | WPRIM | ID: wpr-717228

ABSTRACT

In and after the third trimester, the lung surface is likely to become smooth to facilitate respiratory movements. However, there are no detailed descriptions as to when and how the lung surface becomes regular. According to our observations of 33 fetuses at 9–16 weeks of gestation (crown-rump length [CRL], 39–125 mm), the lung surface, especially its lateral (costal) surface, was comparatively rough due to rapid branching and outward growing of bronchioli at the pseudoglandular phase of lung development. The pulmonary pleura was thin and, beneath the surface mesothelium, no or little mesenchymal tissue was detectable. Veins and lymphatic vessels reached the lung surface until 9 weeks and 16 weeks, respectively. In contrast, in 8 fetuses at 26–34 weeks of gestation (CRL, 210–290 mm), the lung surface was almost smooth because, instead of bronchioli, the developing alveoli faced the external surfaces of the lung. Moreover, the submesothelial tissue became thick due to large numbers of dilated veins connected to deep intersegmental veins. CD34-positive, multilayered fibrous tissue was also evident beneath the mesothelium in these stages. The submesothelial tissue was much thicker at the basal and mediastinal surfaces compared to apical and costal surfaces. Overall, rather than by a mechanical stress from the thoracic wall and diaphragm, a smooth lung surface seemed to be established largely by the thick submesothelial tissue including veins and lymphatic vessels until 26 weeks.


Subject(s)
Diaphragm , Epithelium , Female , Fetus , Humans , Lung , Lymphatic Vessels , Pleura , Pregnancy , Pregnancy Trimester, Third , Stress, Mechanical , Thoracic Wall , Veins
13.
Article in English | WPRIM | ID: wpr-713590

ABSTRACT

BACKGROUND: Intraoperative indocyanine green (ICG) lymphography can effectively detect functioning lymph vessels in edematous limbs. However, it is sometimes difficult to clearly identify their course in later-stage edematous limbs. For this reason, many surgeons rely on experience when they decide where to make the skin incision to locate the lymphatic vessels. The purpose of this study was to elucidate lymphatic vessel flow patterns in healthy upper extremities in a Korean population and to use these findings as a reference for lymphedema treatment. METHODS: ICG fluorescence lymphography was performed by injecting 1 mL of ICG into the second web space of the hand. After 4 hours, fluorescence images of lymphatic vessels were obtained with a near-infrared camera, and the lymphatic vessels were marked. Three landmarks were designated: the radial styloid process, the mid-portion of the cubital fossa, and the lower border of the deltopectoral groove. A straight line connecting the points was drawn, and the distance between the connected lines and the marked lymphatic vessels was measured at 8 points. RESULTS: There were 30 healthy upper extremities (15 right and 15 left). The average course of the main lymph vessels passed 26.0±11.6 mm dorsal to the styloid process, 5.7±40.7 mm medial to the mid-cubital fossa, and 31.3±26.1 mm medial to the three-quarters point of the upper landmark line. CONCLUSIONS: The main functioning lymphatic vessel follows the course of the cephalic vein at the forearm level, crosses the mid-cubital point, and travels medially toward the mid-axilla.


Subject(s)
Extremities , Fluorescence , Forearm , Hand , Indocyanine Green , Lymphatic Vessels , Lymphedema , Lymphography , Skin , Surgeons , Upper Extremity , Veins
14.
Article in Korean | WPRIM | ID: wpr-738960

ABSTRACT

Lymphangioma of the esophagus is a rare submucosal benign tumor. A 49-year-old man was referred because of a foreign body sensation in the esophagus. In endoscopy, a 10.0×1.0-cm longitudinal, translucent, whitish yellow mass covered with normal esophageal mucosa was found in the lower esophagus. Endoscopic ultrasonography revealed a heterogeneous, mainly hypoechoic, well-circumscribed lesion located in the third layer. Incisional biopsy was performed, and histologic findings showed multiple dilated lymphatic vessels, consistent with lymphangioma. After 3 months of proton pump inhibitor treatment, the symptom was relieved and the patient is currently asymptomatic and under surveillance.


Subject(s)
Biopsy , Endoscopy , Endosonography , Esophagus , Foreign Bodies , Humans , Lymphangioma , Lymphatic Vessels , Middle Aged , Mucous Membrane , Proton Pumps , Sensation
15.
Medisan ; 21(3)mar. 2017. ilus
Article in Spanish | LILACS | ID: biblio-841675

ABSTRACT

Se presenta el caso clínico de una lactante de 8 meses de edad, de procedencia rural, quien ingresa en el Hospital Docente Infantil Norte de Santiago de Cuba por presentar fiebre, vómitos y diarreas. Se le realizó examen físico y observación de la vena digital, cuyo resultado desde el punto de vista de la medicina tradicional fue diarrea por frío-humedad, para lo cual se orientó una estrategia terapéutica que favoreció la mejoría del cuadro diarreico y emético, sin el empleo de medicamentos


The case report of an 8 months infant is presented. She had rural origin and is admitted to the Northern Teaching Children Hospital in Santiago de Cuba due to fever, vomits and diarrheas. Physical examination and observation of the digital vein was carried out whose result from the traditional medicine point of view was diarrhea due to cold-humidity, for which a therapeutic strategy was guided that favored the improvement of the diarrheal and emetic pattern, without using medication


Subject(s)
Humans , Female , Infant , Diarrhea , Diarrhea, Infantile/therapy , Fingers/blood supply , Medicine, Traditional , Vomiting , Lymphatic Vessels , Fever
16.
An. bras. dermatol ; 92(5,supl.1): 11-13, 2017. graf
Article in English | LILACS | ID: biblio-887064

ABSTRACT

Abstract: Lymphangioma is an uncommon benign vascular tumour that involves lymphatic vessels. It can be acquired or, most frequently, congenital. The acquired form presents with dilated lymphatic channels due to an obstruction. These lesions have no risk of malignant transformation, but they have a high rate of recurrence whether removed. We present a case of a 52-year-old woman with acquired lymphangiomas mimicking warts. She came to our observation for some keratotic lesions on her feet. Clinically, we found three warts on the sole of her left foot, but we also noticed the presence of swelling and papillomatous wart-like papules on both halluces. The hallux papules were studied by performing an excisional biopsy and were found to be lymphangiomas.


Subject(s)
Humans , Female , Middle Aged , Skin Neoplasms/pathology , Warts/pathology , Hallux/pathology , Lymphangioma/pathology , Biopsy , Lymphatic Vessels/pathology , Diagnosis, Differential
17.
Article in Korean | WPRIM | ID: wpr-122516

ABSTRACT

Intralymphatic histiocytosis (IH) is a rare disease with variable and nonspecific clinical features, but with characteristic histopathological findings. Histopathologically, dilated lymphatic vessels containing aggregates of mononuclear cells are observed near the reticular dermis. IH is often associated with other diseases, such as rheumatoid arthritis, osteoarthritis, joint metal implantation, and with breast cancer where it occurs over the mastectomy scar. Although the pathogenesis of IH is not defined, some authors have suggested that lymphatic vessel engorgement by histiocytes migrating from neighboring inflammatory reactions may play a key pathogenic role. We present a case of IH associated with breast cancer. A 50-year-old female developed multiple tender erythematous plaques on both breasts and the right shoulder 3 years after bilateral mastectomy. To our knowledge, this is the first case of IH in association with breast cancer in the Korean dermatologic literature.


Subject(s)
Arthritis, Rheumatoid , Breast Neoplasms , Breast , Cicatrix , Dermis , Female , Histiocytes , Histiocytosis , Humans , Joints , Lymphatic Vessels , Mastectomy , Middle Aged , Osteoarthritis , Rare Diseases , Shoulder
18.
Article in English | WPRIM | ID: wpr-127859

ABSTRACT

OBJECTIVE: Para-aortic indocyanine-green (ICG)-guided targeted compartmental lymphadenectomy is feasible in early ovarian cancer; systematic pelvic and para-aortic lymphadenectomy could potentially be avoided if thoroughly investigated sentinel nodes could predict whether residual nodes will be involved or free of disease. In contrast to advanced ovarian cancer, where the therapeutic potential of lymphadenectomy will soon be clarified by the results of the Arbeitsgemeinschaft Gynäkologische Onkologie lymphadenectomy in ovarian neoplasms (AGO LION) trial, systematic lymphadenectomy seems to be mandatory for diagnostic and also therapeutic purposes in early ovarian cancer. Sentinel node biopsy or resection of the regional lymphatic network may reduce morbidity compared to systematic lymphadenectomy as shown already for other entities. Apart from the ovarian mesonephric pathway, a second Müllerian uterine pathway exists for lymphatic drainage of the ovary. Lymphatic valves apparently do not exist at this level of the utero-ovarian network since injection of radioactivity into the ovarian ligaments also labelled pelvic nodes. METHODS: We applied ICG using 4×0.5 mL of a 1.66 mg/mL ICG solution for transcervical injection into the fundal and midcorporal myometrium at each side instead of injection into the infundibulopelvic ligament, since the utero-ovarian drainage was intact. RESULTS: In this case a 1.8 cm cancer of the right ovary was removed in continuity with its draining lymphatic vessels and at least the first 2 sentinel nodes in each channel “en bloc” as shown in this video for the pelvic part, consistent with the loco-regional ontogenetic approach. CONCLUSION: This could potentially avoid most of systematic lymphadenectomies in early ovarian cancer.


Subject(s)
Animals , Biopsy , Drainage , Female , Indocyanine Green , Ligaments , Lymph Node Excision , Lymphatic Vessels , Mice , Myometrium , Ovarian Neoplasms , Ovary , Radioactivity
19.
Article in English | WPRIM | ID: wpr-159879

ABSTRACT

Cystic lymphangioma is a true, benign, congenital multicystic tumor arising from sequestrations of embryonic lymphatic tissue. Most often it occurs at birth or during the early years of life, is found most commonly in the neck, and its distribution coincides with that of the primitive lymph sacs. A 23-year-woman presented with a soft palpable mass on her chest wall. Physical and ultrasound examination revealed a well-circumscribed, mobile, nontender, soft subcutaneous mass on the right posterior chest wall beneath the latissimus dorsi muscle. A skin biopsy of the mass showed endothelium-lined lymphatic vessels and a loose, lace-like fibrous tissue stroma. The specimen was stained with D2-40 showing positive staining of lymphatics. These histopathological findings confirmed the diagnosis of a cystic lymphangioma. We report a rare case of a cystic lymphangioma on the chest wall in a 23-year-old woman.


Subject(s)
Adult , Biopsy , Diagnosis , Female , Humans , Lymphangioma, Cystic , Lymphatic Vessels , Lymphoid Tissue , Neck , Parturition , Skin , Superficial Back Muscles , Thoracic Wall , Thorax , Ultrasonography , Young Adult
20.
Article in English | WPRIM | ID: wpr-163713

ABSTRACT

OBJECTIVE: Whether pelvic and para-aortic lymphadenectomy is of therapeutic benefit in advanced ovarian cancer will remain unclear until the publication of the Arbeitsgemeinschaft Gynäkologische Onkologie lymphadenectomy in ovarian neoplasms (AGO LION) trial. In early ovarian cancer, however, lymphadenectomy seems mandatory for diagnostic and also therapeutic reasons. METHODS: Complete systematic lymphadenectomy is accompanied by morbidity which may be reduced by sentinel node biopsy already established for several solid tumors. In ovarian cancer there are 2 main pathways in lymphatic drainage: along the ovarian vessels to the para-aortic nodes and the uterine vessels to the iliac lymph compartments. Following injection of radioactive dye into the ovarian ligaments this could be confirmed suggesting that there is bidirectional flow at this level of the ovarian and uterine lymphatic pathways. Indocyanine-green-guided (ICG) injection to the uterine corpus seems to be equally effective in labelling the “uterine Müllerian” and the “ovarian mesonephric” lymphatic drainage of the ovary. RESULTS: This technique was applied and will be outlined in the video showing the procedure with respect to the para-aortic lymphatic drainage. Isolated sentinel node biopsy and tumor excision will not resect the organ compartment together with its super-ordinated draining lymphatic system at risk. CONCLUSION: Thus, the authors suggest to remove the malignancy together with its draining lymphatic vessels and at least the first 2 sentinel nodes in each channel en bloc; we propose to analyze this procedure consistent with the ontogenetic approach with respect to diagnostic accuracy and loco-regional control. This could potentially avoid most of systematic lymphadenectomies in early ovarian cancer.


Subject(s)
Biopsy , Drainage , Female , Indocyanine Green , Ligaments , Lymph Node Excision , Lymphatic System , Lymphatic Vessels , Ovarian Neoplasms , Ovary , Publications
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