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

ABSTRACT

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.