Journal articles: 'Lymphangion'

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Venugopal, Arun M., Randolph H. Stewart, Glen A. Laine, Ranjeet M. Dongaonkar, and Christopher M. Quick. "Lymphangion coordination minimally affects mean flow in lymphatic vessels." American Journal of Physiology-Heart and Circulatory Physiology 293, no. 2 (August 2007): H1183—H1189. http://dx.doi.org/10.1152/ajpheart.01340.2006.

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The lymphatic system returns interstitial fluid to the central venous circulation, in part, by the cyclical contraction of a series of “lymphangion pumps” in a lymphatic vessel. The dynamics of individual lymphangions have been well characterized in vitro; their frequencies and strengths of contraction are sensitive to both preload and afterload. However, lymphangion interaction within a lymphatic vessel has been poorly characterized because it is difficult to experimentally alter properties of individual lymphangions and because the afterload of one lymphangion is coupled to the preload of another. To determine the effects of lymphangion interaction on lymph flow, we adapted an existing mathematical model of a lymphangion (characterizing lymphangion contractility, lymph viscosity, and inertia) to create a new lymphatic vessel model consisting of several lymphangions in series. The lymphatic vessel model was validated with focused experiments on bovine mesenteric lymphatic vessels in vitro. The model was then used to predict changes in lymph flow with different time delays between onset of contraction of adjacent lymphangions (coordinated case) and with different relative lymphangion contraction frequencies (noncoordinated case). Coordination of contraction had little impact on mean flow. Furthermore, orthograde and retrograde propagations of contractile waves had similar effects on flow. Model results explain why neither retrograde propagation of contractile waves nor the lack of electrical continuity between lymphangions adversely impacts flow. Because lymphangion coordination minimally affects mean flow in lymphatic vessels, lymphangions have flexibility to independently adapt to local conditions.

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Quick, Christopher M., Arun M. Venugopal, Ranjeet M. Dongaonkar, Glen A. Laine, and Randolph H. Stewart. "First-order approximation for the pressure-flow relationship of spontaneously contracting lymphangions." American Journal of Physiology-Heart and Circulatory Physiology 294, no. 5 (May 2008): H2144—H2149. http://dx.doi.org/10.1152/ajpheart.00781.2007.

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To return lymph to the great veins of the neck, it must be actively pumped against a pressure gradient. Mean lymph flow in a portion of a lymphatic network has been characterized by an empirical relationship (Pin − Pout = −Pp + RLQL), where Pin − Pout is the axial pressure gradient and QL is mean lymph flow. RL and Pp are empirical parameters characterizing the effective lymphatic resistance and pump pressure, respectively. The relation of these global empirical parameters to the properties of lymphangions, the segments of a lymphatic vessel bounded by valves, has been problematic. Lymphangions have a structure like blood vessels but cyclically contract like cardiac ventricles; they are characterized by a contraction frequency ( f) and the slopes of the end-diastolic pressure-volume relationship [minimum value of resulting elastance ( Emin)] and end-systolic pressure-volume relationship [maximum value of resulting elastance ( Emax)]. Poiseuille's law provides a first-order approximation relating the pressure-flow relationship to the fundamental properties of a blood vessel. No analogous formula exists for a pumping lymphangion. We therefore derived an algebraic formula predicting lymphangion flow from fundamental physical principles and known lymphangion properties. Quantitative analysis revealed that lymph inertia and resistance to lymph flow are negligible and that lymphangions act like a series of interconnected ventricles. For a single lymphangion, Pp = Pin ( Emax − Emin)/ Emin and RL = Emax/ f. The formula was tested against a validated, realistic mathematical model of a lymphangion and found to be accurate. Predicted flows were within the range of flows measured in vitro. The present work therefore provides a general solution that makes it possible to relate fundamental lymphangion properties to lymphatic system function.

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Bertram, Christopher D., Charlie Macaskill, Michael J. Davis, and James E. Moore. "Consequences of intravascular lymphatic valve properties: a study of contraction timing in a multi-lymphangion model." American Journal of Physiology-Heart and Circulatory Physiology 310, no. 7 (April 1, 2016): H847—H860. http://dx.doi.org/10.1152/ajpheart.00669.2015.

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The observed properties of valves in collecting lymphatic vessels include transmural pressure-dependent bias to the open state and hysteresis. The bias may reduce resistance to flow when the vessel is functioning as a conduit. However, lymphatic pumping implies a streamwise increase in mean pressure across each valve, suggesting that the bias is then potentially unhelpful. Lymph pumping by a model of several collecting lymphatic vessel segments (lymphangions) in series, which incorporated these properties, was investigated under conditions of adverse pressure difference while varying the refractory period between active muscular contractions and the inter-lymphangion contraction delay. It was found that many combinations of the timing parameters and the adverse pressure difference led to one or more intermediate valves remaining open instead of switching between open and closed states during repetitive contraction cycles. Cyclic valve switching was reliably indicated if the mean pressure in a lymphangion over a cycle was higher than that in the lymphangion upstream, but either lack of or very brief valve closure could cause mean pressure to be lower downstream. Widely separated combinations of refractory period and delay time were found to produce the greatest flow-rate for a given pressure difference. The efficiency of pumping was always maximized by a long refractory period and lymphangion contraction starting when the contraction of the lymphangion immediately upstream was peaking. By means of an ex vivo experiment, it was verified that intermediate valves in a chain of pumping lymphangions can remain open, while the lymphangions on either side of the open valve continue to execute contractions.

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Venugopal, Arun M., Christopher M. Quick, Glen A. Laine, and Randolph H. Stewart. "Optimal postnodal lymphatic network structure that maximizes active propulsion of lymph." American Journal of Physiology-Heart and Circulatory Physiology 296, no. 2 (February 2009): H303—H309. http://dx.doi.org/10.1152/ajpheart.00360.2008.

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The lymphatic system acts to return lower-pressured interstitial fluid to the higher-pressured veins by a complex network of vessels spanning more than three orders of magnitude in size. Lymphatic vessels consist of lymphangions, segments of vessels between two unidirectional valves, which contain smooth muscle that cyclically pumps lymph against a pressure gradient. Whereas the principles governing the optimal structure of arterial networks have been identified by variations of Murray's law, the principles governing the optimal structure of the lymphatic system have yet to be elucidated, although lymph flow can be identified as a critical parameter. The reason for this deficiency can be identified. Until recently, there has been no algebraic formula, such as Poiseuille's law, that relates lymphangion structure to its function. We therefore employed a recently developed mathematical model, based on the time-varying elastance model conventionally used to describe ventricular function, that was validated by data collected from postnodal bovine mesenteric lymphangions. From this lymphangion model, we developed a model to determine the structure of a lymphatic network that optimizes lymph flow. The model predicted that there is a lymphangion length that optimizes lymph flow and that symmetrical networks optimize lymph flow when the lymphangions downstream of a bifurcation are 1.26 times the length of the lymphangions immediately upstream. Measured lymphangion lengths (1.14 ± 0.5 cm, n = 74) were consistent with the range of predicted optimal lengths (0.1–2.1 cm). This modeling approach was possible, because it allowed a structural parameter, such as length, to be treated as a variable.

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Venugopal, Arun M., Randolph H. Stewart, Glen A. Laine, and Christopher M. Quick. "Nonlinear lymphangion pressure-volume relationship minimizes edema." American Journal of Physiology-Heart and Circulatory Physiology 299, no. 3 (September 2010): H876—H882. http://dx.doi.org/10.1152/ajpheart.00239.2009.

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Lymphangions, the segments of lymphatic vessel between two valves, contract cyclically and actively pump, analogous to cardiac ventricles. Besides having a discernable systole and diastole, lymphangions have a relatively linear end-systolic pressure-volume relationship (with slope Emax) and a nonlinear end-diastolic pressure-volume relationship (with slope Emin). To counter increased microvascular filtration (causing increased lymphatic inlet pressure), lymphangions must respond to modest increases in transmural pressure by increasing pumping. To counter venous hypertension (causing increased lymphatic inlet and outlet pressures), lymphangions must respond to potentially large increases in transmural pressure by maintaining lymph flow. We therefore hypothesized that the nonlinear lymphangion pressure-volume relationship allows transition from a transmural pressure-dependent stroke volume to a transmural pressure-independent stroke volume as transmural pressure increases. To test this hypothesis, we applied a mathematical model based on the time-varying elastance concept typically applied to ventricles (the ratio of pressure to volume cycles periodically from a minimum, Emin, to a maximum, Emax). This model predicted that lymphangions increase stroke volume and stroke work with transmural pressure if Emin < Emax at low transmural pressures, but maintain stroke volume and stroke work if Emin= Emax at higher transmural pressures. Furthermore, at higher transmural pressures, stroke work is evenly distributed among a chain of lymphangions. Model predictions were tested by comparison to previously reported data. Model predictions were consistent with reported lymphangion properties and pressure-flow relationships of entire lymphatic systems. The nonlinear lymphangion pressure-volume relationship therefore minimizes edema resulting from both increased microvascular filtration and venous hypertension.

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Razavi, Mohammad S., Tyler S. Nelson, Zhanna Nepiyushchikh, Rudolph L. Gleason, and J. Brandon Dixon. "The relationship between lymphangion chain length and maximum pressure generation established through in vivo imaging and computational modeling." American Journal of Physiology-Heart and Circulatory Physiology 313, no. 6 (December 1, 2017): H1249—H1260. http://dx.doi.org/10.1152/ajpheart.00003.2017.

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The intrinsic contraction of collecting lymphatic vessels serves as a pumping system to propel lymph against hydrostatic pressure gradients as it returns interstitial fluid to the venous circulation. In the present study, we proposed and validated that the maximum opposing outflow pressure along a chain of lymphangions at which flow can be achieved increases with the length of chain. Using minimally invasive near-infrared imaging to measure the effective pumping pressure at various locations in the rat tail, we demonstrated increases in pumping pressure along the length of the tail. Computational simulations based on a microstructurally motivated model of a chain of lymphangions informed from biaxial testing of isolated vessels was used to provide insights into the pumping mechanisms responsible for the pressure increases observed in vivo. These models suggest that the number of lymphangions in the chain and smooth muscle cell force generation play a significant role in determining the maximum outflow pressure, whereas the frequency of contraction has no effect. In vivo administration of nitric oxide attenuated lymphatic contraction, subsequently lowering the effective pumping pressure. Computational simulations suggest that the reduction in contractile strength of smooth muscle cells in the presence of nitric oxide can account for the reductions in outflow pressure observed along the lymphangion chain in vivo. Thus, combining modeling with multiple measurements of lymphatic pumping pressure provides a method for approximating intrinsic lymphatic muscle activity noninvasively in vivo while also providing insights into factors that determine the extent that a lymphangion chain can transport fluid against an adverse pressure gradient. NEW & NOTEWORTHY Here, we report the first minimally invasive in vivo measurements of the relationship between lymphangion chain length and lymphatic pumping pressure. We also provide the first in vivo validation of lumped parameter models of lymphangion chains previously developed through data obtained from isolated vessel testing.

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Mozokhina, Anastasia, and Rostislav Savinkov. "Mathematical Modelling of the Structure and Function of the Lymphatic System." Mathematics 8, no. 9 (September 1, 2020): 1467. http://dx.doi.org/10.3390/math8091467.

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This paper presents current knowledge about the structure and function of the lymphatic system. Mathematical models of lymph flow in the single lymphangion, the series of lymphangions, the lymph nodes, and the whole lymphatic system are considered. The main results and further perspectives are discussed.

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Bubnova, N. A., R. P. Borisova, and N. A. Kubyshkina. "Theory of active lymph transport: morphofunctional foundations and clinical aspects." Regional blood circulation and microcirculation 19, no. 3 (October 7, 2020): 80–89. http://dx.doi.org/10.24884/1682-6655-2020-19-3-80-89.

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Its given significance of lymphangion as a structural-functional unit in the new theory of structure and functions of the lymphatic system. The construction of lymphangion in pathogenesis of lymph edema is represented. Treatment and prophylaxis must be directed at all parts of the lymphatic system.

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Dongaonkar, R. M., T. L. Nguyen, C. M. Quick, C. L. Heaps, J. Hardy, G. A. Laine, E. Wilson, and R. H. Stewart. "Mesenteric lymphatic vessels adapt to mesenteric venous hypertension by becoming weaker pumps." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 308, no. 5 (March 1, 2015): R391—R399. http://dx.doi.org/10.1152/ajpregu.00196.2014.

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Lymphangions, the segments of lymphatic vessels between two adjacent lymphatic valves, actively pump lymph. Acute changes in transmural pressure and lymph flow have profound effects on lymphatic pump function in vitro. Chronic changes in pressure and flow in vivo have also been reported to lead to significant changes in lymphangion function. Because changes in pressure and flow are both cause and effect of adaptive processes, characterizing adaptation requires a more fundamental analysis of lymphatic muscle properties. Therefore, the purpose of the present work was to use an intact lymphangion isovolumetric preparation to evaluate changes in mesenteric lymphatic muscle mechanical properties and the intracellular Ca2+ in response to sustained mesenteric venous hypertension. Bovine mesenteric veins were surgically occluded to create mesenteric venous hypertension. Postnodal mesenteric lymphatic vessels from mesenteric venous hypertension (MVH; n = 6) and sham surgery (Sham; n = 6) animals were isolated and evaluated 3 days after the surgery. Spontaneously contracting MVH vessels generated end-systolic active tension and end-diastolic active tension lower than the Sham vessels. Furthermore, steady-state active tension and intracellular Ca2+ concentration levels in response to KCl stimulation were also significantly lower in MVH vessels compared with those of the Sham vessels. There was no significant difference in passive tension in lymphatic vessels from the two groups. Taken together, these results suggest that following 3 days of mesenteric venous hypertension, postnodal mesenteric lymphatic vessels adapt to become weaker pumps with decreased cytosolic Ca2+ concentration.

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Davis, Michael J., Joshua P. Scallan, John H. Wolpers, Mariappan Muthuchamy, Anatoliy A. Gashev, and David C. Zawieja. "Intrinsic increase in lymphangion muscle contractility in response to elevated afterload." American Journal of Physiology-Heart and Circulatory Physiology 303, no. 7 (October 1, 2012): H795—H808. http://dx.doi.org/10.1152/ajpheart.01097.2011.

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Collecting lymphatic vessels share functional and biochemical characteristics with cardiac muscle; thus, we hypothesized that the lymphatic vessel pump would exhibit behavior analogous to homeometric regulation of the cardiac pump in its adaptation to elevated afterload, i.e., an increase in contractility. Single lymphangions containing two valves were isolated from the rat mesenteric microcirculation, cannulated, and pressurized for in vitro study. Pressures at either end of the lymphangion [input pressure (Pin), preload; output pressure (Pout), afterload] were set by a servo controller. Intralymphangion pressure (PL) was measured using a servo-null micropipette while internal diameter and valve positions were monitored using video methods. The responses to step- and ramp-wise increases in Pout (at low, constant Pin) were determined. PL and diameter data recorded during single contraction cycles were used to generate pressure-volume (P-V) relationships for the subsequent analysis of lymphangion pump behavior. Ramp-wise Pout elevation led to progressive vessel constriction, a rise in end-systolic diameter, and an increase in contraction frequency. Step-wise Pout elevation produced initial vessel distention followed by time-dependent declines in end-systolic and end-diastolic diameters. Significantly, a 30% leftward shift in the end-systolic P-V relationship accompanied an 84% increase in dP/d t after a step increase in Pout, consistent with an increase in contractility. Calculations of stroke work from the P-V loop area revealed that robust pumps produced net positive work to expel fluid throughout the entire afterload range, whereas weaker pumps exhibited progressively more negative work as gradual afterload elevation led to pump failure. We conclude that lymphatic muscle adapts to output pressure elevation with an intrinsic increase in contractility and that this compensatory mechanism facilitates the maintenance of lymph pump output in the face of edemagenic and/or gravitational loads.

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Jamalian, Samira, Christopher D. Bertram, William J. Richardson, and James E. Moore. "Parameter sensitivity analysis of a lumped-parameter model of a chain of lymphangions in series." American Journal of Physiology-Heart and Circulatory Physiology 305, no. 12 (December 15, 2013): H1709—H1717. http://dx.doi.org/10.1152/ajpheart.00403.2013.

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Any disruption of the lymphatic system due to trauma or injury can lead to edema. There is no effective cure for lymphedema, partly because predictive knowledge of lymphatic system reactions to interventions is lacking. A well-developed model of the system could greatly improve our understanding of its function. Lymphangions, defined as the vessel segment between two valves, are the individual pumping units. Based on our previous lumped-parameter model of a chain of lymphangions, this study aimed to identify the parameters that affect the system output the most using a sensitivity analysis. The system was highly sensitive to minimum valve resistance, such that variations in this parameter caused an order-of-magnitude change in time-average flow rate for certain values of imposed pressure difference. Average flow rate doubled when contraction frequency was increased within its physiological range. Optimum lymphangion length was found to be some 13–14.5 diameters. A peak of time-average flow rate occurred when transmural pressure was such that the pressure-diameter loop for active contractions was centered near maximum passive vessel compliance. Increasing the number of lymphangions in the chain improved the pumping in the presence of larger adverse pressure differences. For a given pressure difference, the optimal number of lymphangions increased with the total vessel length. These results indicate that further experiments to estimate valve resistance more accurately are necessary. The existence of an optimal value of transmural pressure may provide additional guidelines for increasing pumping in areas affected by edema.

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Quick, Christopher M., Arun M. Venugopal, Anatoliy A. Gashev, David C. Zawieja, and Randolph H. Stewart. "Intrinsic pump-conduit behavior of lymphangions." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 292, no. 4 (April 2007): R1510—R1518. http://dx.doi.org/10.1152/ajpregu.00258.2006.

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Lymphangions, segments of lymphatic vessels bounded by valves, have characteristics of both ventricles and arteries. They can act primarily like pumps when actively transporting lymph against a pressure gradient. They also can act as conduit vessels when passively transporting lymph down a pressure gradient. This duality has implications for clinical treatment of several types of edema, since the strategy to optimize lymph flow may depend on whether it is most beneficial for lymphangions to act as pumps or conduits. To address this duality, we employed a simple computational model of a contracting lymphangion, predicted the flows at both positive and negative axial pressure gradients, and validated the results with in vitro experiments on bovine mesenteric vessels. This model illustrates that contraction increases flow for normal axial pressure gradients. With edema, limb elevation, or external compression, however, the pressure gradient might reverse, and lymph may flow passively down a pressure gradient. In such cases, the valves may be forced open during the entire contraction cycle. The vessel thus acts as a conduit, and contraction has the effect of increasing resistance to passive flow, thus inhibiting flow rather than promoting it. This analysis may explain a possible physiological benefit of the observed flow-mediated inhibition of the lymphatic pump at high flow rates.

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Scallan, Joshua P., John H. Wolpers, Mariappan Muthuchamy, David C. Zawieja, Anatoliy A. Gashev, and Michael J. Davis. "Independent and interactive effects of preload and afterload on the pump function of the isolated lymphangion." American Journal of Physiology-Heart and Circulatory Physiology 303, no. 7 (October 1, 2012): H809—H824. http://dx.doi.org/10.1152/ajpheart.01098.2011.

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We tested the responses of single, isolated lymphangions to selective changes in preload and the effects of changing preload on the response to an imposed afterload. The methods used were similar to those described in our companion paper. Step-wise increases in input pressure (Pin; preload) over a pressure range between 0.5 and 3 cmH2O, at constant output pressure (Pout), led to increases in end-diastolic diameter, decreases in end-systolic diameter, and increases in stroke volume. From a baseline of 1 cmH2O, Pin elevation by 2–7 cmH2O consistently produced an immediate fall in stroke volume that subsequently recovered over a time course of 2–3 min. Surprisingly, this adaptation was associated with an increase in the slope of the end-systolic pressure-volume relationship, indicative of an increase in contractility. Lymphangions subjected to Pout levels exceeding their initial ejection limit would often accommodate by increasing diastolic filling to strengthen contraction sufficiently to match Pout. The lymphangion adaptation to various pressure combinations (Pin ramps with low or high levels of Pout, Pout ramps at low or intermediate levels of Pin, and combined Pin + Pout ramps) were analyzed using pressure-volume data to calculate stroke work. Under relatively low imposed loads, stroke work was maximal at low preloads (Pin ∼2 cmH2O), whereas at more elevated afterloads, the optimal preload for maximal work displayed a broad plateau over a Pin range of 5–11 cmH2O. These results provide new insights into the normal operation of the lymphatic pump, its comparison with the cardiac pump, and its potential capacity to adapt to increased loads during edemagenic and/or gravitational stress.

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Quick, Christopher M., Bruce L. Ngo, Arun M. Venugopal, and Randolph H. Stewart. "Lymphatic pump-conduit duality: contraction of postnodal lymphatic vessels inhibits passive flow." American Journal of Physiology-Heart and Circulatory Physiology 296, no. 3 (March 2009): H662—H668. http://dx.doi.org/10.1152/ajpheart.00322.2008.

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Lymphangions, the segments of lymphatic vessels between valves, exhibit structural characteristics in common with both ventricles and arteries. Although once viewed as passive conduits like arteries, it has become well established that lymphangions can actively pump lymph against an axial pressure gradient from low-pressure tissues to the great veins of the neck. A recently reported mathematical model, based on fundamental principles, predicted that lymphangions can transition from pump to conduit behavior when outlet pressure falls below inlet pressure. In this case, the axial pressure gradient becomes the major source of energy for the propulsion of lymph, despite the presence of cyclical contraction. In fact, flow is augmented when cyclical contractions are abolished. We therefore used an in vitro preparation to confirm these findings and to test the hypothesis that lymphangion contraction inhibits flow when outlet pressure falls below inlet pressure. Bovine postnodal mesenteric lymphatic vessels harvested from an abattoir were subjected to an inlet pressure of 5.0 cmH2O and an outlet pressure that decreased from 6.5 to 3.5 cmH2O under control conditions, stimulated with U-46619 (a thromboxane analog) and relaxed with calcium-free solution. Under control conditions, lymphatic flow markedly increased as outlet pressure fell below inlet pressure. In this case, the slopes of the flow versus axial pressure gradient increased with calcium-free conditions (61%, n = 8, P = 0.016) and decreased with U-46619 stimulation (21%, n = 5, P = 0.033). Our findings indicate that the stimulation of lymphatic contractility does indeed inhibit lymphatic flow when vessels act like conduits.

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van Helden, Dirk F. "The lymphangion: a not so ‘primitive’ heart." Journal of Physiology 592, no. 24 (December 15, 2014): 5353–54. http://dx.doi.org/10.1113/jphysiol.2014.286039.

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Rahbar, Elaheh, and James E. Moore. "A model of a radially expanding and contracting lymphangion." Journal of Biomechanics 44, no. 6 (April 2011): 1001–7. http://dx.doi.org/10.1016/j.jbiomech.2011.02.018.

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Nagy, Andreas, Christian Fretz, Steffen Bergelt, Gian-Marco Semadeni, and Christa Meyenberger. "Mesenteriales, zystisches Lymphangiom beim Erwachsenen – eine Rarität als Zufallsbefund." Praxis 105, no. 20 (September 2016): 1213–16. http://dx.doi.org/10.1024/1661-8157/a002482.

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Zusammenfassung. Im Rahmen einer urologischen Abklärung wurde bei einem 69-jährigen Patienten als Zufallsbefund eine langstreckige Wandverdickung des Dünndarms mit zystischer Komponente diagnostiziert, die sich als mesenteriales Lymphangiom herausstellte. Mesenteriale, zystische Lymphangiome sind seltene, benigne Malformationen des lymphatischen Systems, die sich vor allem im Kindesalter manifestieren. Sie sollten jedoch auch bei Erwachsenen bei der Differenzialdiagnose von abdominalen zystischen Läsionen oder beim akuten Abdomen in Betracht gezogen werden. Die präoperative Diagnostik basiert auf bildgebenden Modalitäten (Sonografie, CT, MRI). Selbst wenn Lymphangiome asymptomatisch sind und Zufallsbefunde darstellen, sollten sie aufgrund potenzieller Komplikationen wie Blutungen, Ruptur, Volvulus oder Infektionen chirurgisch behandelt werden. Die optimale Therapie stellt die vollständige Exzision dar.

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Bertram, C. D., C. Macaskill, M. J. Davis, and J. E. Moore. "Development of a model of a multi-lymphangion lymphatic vessel incorporating realistic and measured parameter values." Biomechanics and Modeling in Mechanobiology 13, no. 2 (June 26, 2013): 401–16. http://dx.doi.org/10.1007/s10237-013-0505-0.

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Wang, Mingjie, Zhiguo Yuan, Ning Ma, Chunxiang Hao, Weimin Guo, Gengyi Zou, Yu Zhang, et al. "Advances and Prospects in Stem Cells for Cartilage Regeneration." Stem Cells International 2017 (2017): 1–16. http://dx.doi.org/10.1155/2017/4130607.

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The histological features of cartilage call attention to the fact that cartilage has a little capacity to repair itself owing to the lack of a blood supply, nerves, or lymphangion. Stem cells have emerged as a promising option in the field of cartilage tissue engineering and regenerative medicine and could lead to cartilage repair. Much research has examined cartilage regeneration utilizing stem cells. However, both the potential and the limitations of this procedure remain controversial. This review presents a summary of emerging trends with regard to using stem cells in cartilage tissue engineering and regenerative medicine. In particular, it focuses on the characterization of cartilage stem cells, the chondrogenic differentiation of stem cells, and the various strategies and approaches involving stem cells that have been used in cartilage repair and clinical studies. Based on the research into chondrocyte and stem cell technologies, this review discusses the damage and repair of cartilage and the clinical application of stem cells, with a view to increasing our systematic understanding of the application of stem cells in cartilage regeneration; additionally, several advanced strategies for cartilage repair are discussed.

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Khafiz’yanova, R. Kh, G. N. Aleyeva, and D. A. Mukhutdinov. "Lymphotropic effect of dimephosphon, mexidol, and ketorolac is realized via activation of the lymphangion and stimulation of lymph formation." Bulletin of Experimental Biology and Medicine 143, no. 4 (April 2007): 446–48. http://dx.doi.org/10.1007/s10517-007-0152-5.

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Eisenhoffer, J., A. Kagal, T. Klein, and M. G. Johnston. "Importance of Valves and Lymphangion Contractions in Determining Pressure Gradients in Isolated Lymphatics Exposed to Elevations in Outflow Pressure." Microvascular Research 49, no. 1 (January 1995): 97–110. http://dx.doi.org/10.1006/mvre.1995.1008.

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Medina-Rodríguez, María Elena, María de-la-Casa-Almeida, Efrén Martel-Almeida, Arminda Ojeda-Cárdenes, and Esther M. Medrano-Sánchez. "Visualization of Accessory Lymphatic Pathways, before and after Manual Drainage, in Secondary Upper Limb Lymphedema Using Indocyanine Green Lymphography." Journal of Clinical Medicine 8, no. 11 (November 8, 2019): 1917. http://dx.doi.org/10.3390/jcm8111917.

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Manual Lymphatic Drainage (MLD) appears to stimulate lymphatic contraction, aid in the development of secondary derivation pathways, and stimulate the appearance of collateral pathways that could function as the main drainage routes of the limb in case of lymphedema. Through stretching, call up maneuvers are used to stimulate lymphangion reflex contraction and, therefore, lymphatic function. The aim was to describe the presence of areas and pathways of collateral lymphatic drainage under basal conditions and to determine, using Indocyanine Green (ICG) lymphography, whether an increase in these pathways occurs after 30 min of manual lymphatic stimulation with only call up maneuvers according to the Leduc Method®®. In this prospective analytical study (pretest–posttest), the frequency of presentation of areas and collateral lymphatic pathways was analyzed in 19 patients with secondary lymphedema of the upper limb after breast cancer using an infrared camera. Analyses were completed at three time points: after ICG injection, at baseline (pretest), and after the application of MLD (post-test). The Leduc Method maneuvers were applied to the supraclavicular and axillary nodes, chest, back, Mascagni, and Caplan pathways. The areas visualized in the pretest continued to be visible in the posttest. Additional pathways and fluorescent areas were observed after the maneuvers. The McNemar test showed statistical significance (p = 0.008), the odds ratio was infinite, and the Cohen’s g value was equal to 0.5. Manual stimulation by call up maneuvers increased the observation frequency of areas and collateral lymphatic pathways. Therefore, ICG lymphography appears to be a useful tool for bringing out the routes of collateral bypass in secondary lymphoedema after cancer treatment.

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Khafiz'yanova, R. Kh, G. N. Aleeva, and D. A. Mukhutdinov. "Effect of Ketorolac Tromethamine on Lymph Circulation, Contractile Activity of the Lymphangion and Lymphatic Microvessels, and Cellular Composition and Toxicity of the Lymph during Fever." Bulletin of Experimental Biology and Medicine 140, no. 4 (October 2005): 400–402. http://dx.doi.org/10.1007/s10517-005-0502-0.

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Gantsev, S. K., M. A. Tatunov, K. S. Gantsev, S. R. Kzyrgalin, and R. S. Mukhamedyarov. "MICROSURGICAL METHODS OF EX VIVO EXAMINATION OF THE LYMPHATIC SYSTEM IN BREAST CANCER PATIENTS." Siberian journal of oncology 18, no. 3 (June 30, 2019): 71–77. http://dx.doi.org/10.21294/1814-4861-2019-18-3-71-77.

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The purpose of the study was ex vivo examination of lymph node perfusion in patients with metastatic breast cancer.Material and Methods. Lymph nodes affected with metastatic breast cancer were examined. These nodes were subsequently subjected to microsurgical dissection with the isolation of the capsule, lymphatic vessels, parenchyma and stroma. All manipulations were performed after preliminary lymph node dissection using an axillary node sample, and the dissection of an isolated lymph node from this region was then performed. A total of 100 breast cancer patients underwent lymph node dissection and microsurgical lymph node dissection. The control group comprised samples taken from women who died in accidents and had no a history of cancer. Lymph nodes and vessels were isolated from the adipose tissue of the axillary region by the sonolipodestruction technique using LySonix 3000® ultrasonic device with PulseSelect™. A detailed examination of lymph nodes was carried out using OPTON microscope – OPMI 6 CFC and a set of microsurgical instruments. Color lymphography of isolated afferent lymphatic vessels with 0.5 % methylene blue solution was performed. Along with color lymphography, digital morphometry of the components of the lymphatic system (Image-Pro Plus 6.0) and microsurgical dissection of the lymph node capsule and lymphangion valves were performed.Results. Data on non-metastatic and metastatic lymph nodes were obtained and digitally recorded. When studying the metastatic blockade of the lymphoid lobule and afferent lymphatic vessels by the method of antegrade color lymphography, we revealed the compensatory development of lymphatic bypass – intracapsular neo-lymphatic microangiogenesis that was confirmed by histological studies.Conclusion. Color lymphography reliably determines the areas and the extent of functional perfusion. Post-radiation changes in tissues markedly change the logistics of lymph flow and regional metastasis. The lymph node capsule with metastases undergoes a pathological transformation characterized by the development of a network of lymphatic capillaries, the severity of which depends on the extent of metastatic block. Lymph node metastasis changes the lymphatic hydrodynamics by changing the number of lymphatic vessels and their diameter.

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Iqbal, Muhammad, and Wirsma Arif Harahap. "Breasts and Lymphatic Tissue ; A Literature Review." Journal of Midwifery 5, no. 1 (February 22, 2021): 5. http://dx.doi.org/10.25077/jom.5.2.5-13.2020.

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The breasts begin to grow from the sixth week of the embryo in the form of ectodermal thickening along the milk line that lies from the axilla to the middle of the groin (inguinal). The blood supply comes from the internal mammary artery, which is a branch of A. subclavian. Additional bleeding originated from A. axillary through the branches of A. thoracic lateral, A. thoraco dorsalis, and A. thoraco acromialis. The return of blood through the veins follows the passage of the artery to the internal mammary V. and the axillary vein branches to the superior V. kava. Lymph capillaries are located under the epidermis with a diameter between 20 and 70 mm. Lymphangion, as a pacemaker is limited by valves and lymphatic endothelial cells, will initiate an intrinsic pulsation of lymph fluid flow. Extrinsic factors such as contraction of the skeletal muscles, massage, increased hydrostatic pressure by postural gravity can also affect the lymphatic flow rate.5,6 These lymphatic vessels run on the lateral side of the upper arm, parallel to the cephalic vein and drain into the supraclavicular nodes. 4 The LVC is an important anatomical structure for the physiology of vascular lymph node transplantation (VLNT) .8 Lymph vessels in the upper limb travel axially from the fingers to the back of the hand and make direction to the elbow, travel to the anteromedial area at the top of the arm and connect to the axillary lymph nodes in the lateral area. An alternative route directly to the supraclavicular node can be identified. These lymphatic vessels run on the lateral side of the upper arm, parallel to the cephalic veins and drain into the supraclavicular nodes. 4 The LVC is an important anatomical structure for the physiology of vascular lymph node transplantation (VLNT) .8An alternative route directly to the supraclavicular node can be identified. These lymphatic vessels run on the lateral side of the upper arm, parallel to the cephalic veins and drain into the supraclavicular nodes. 4 An alternative route directly to the supraclavicular node can be identified. These lymphatic vessels run on the lateral side of the upper arm, parallel to the cephalic veins and drain into the supraclavicular nodes.

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Egorova, A. A., and E. A. Avramenko. "Experimental faecal peritonitis alters response to 5-hydroxytryptamine in mesenteric lymphatic vessels." Fundamental and Clinical Medicine 5, no. 3 (September 30, 2020): 35–41. http://dx.doi.org/10.23946/2500-0764-2020-5-3-35-41.

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Aim. To compare the reactions to 5-hydroxytryptamine (5-HT, serotonin) in the mesenteric lymphangions upon endothelial denudation and during experimental faecal peritonitis as compared with the control lymphangions. Materials and Methods. Experiments were performed on the intestinal lymph trunk lymphangions of rats using a pressure myograph system. We examined the changes in contraction frequency and amplitude as well as tonic reactions upon the addition of 5-HT (10-8-10-4 M). Experimental peritonitis was caused by an intraperitoneal injection of feces. Results. Faecal peritonitis reduced contraction frequency and amplitude in mesenteric lymphangions. 5-HT increased contraction amplitude only at low concentration (10-8 M) and did not alter the tonic reactions. Upon endothelial denudation, serotonin inhibited contraction frequency and amplitude in the lymphangions. As 5-HT stimulates motility through 5-НТ2 receptors and α2-adrenoceptors on endothelial cells, faecal peritonitis abates the sensitivity of such receptors to 5-HT. Conclusion. In experimental faecal peritonitis, alterations in lymphatic vessels are reminiscent of those in blood vessels. Endothelial dysfunction disturbs the response of lymphatic vessels to 5-HT.

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Benoit, J. N. "Relationships between lymphatic pump flow and total lymph flow in the small intestine." American Journal of Physiology-Heart and Circulatory Physiology 261, no. 6 (December 1, 1991): H1970—H1978. http://dx.doi.org/10.1152/ajpheart.1991.261.6.h1970.

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Response of collecting lymphatics to acute elevations in lymph formation was studied in vivo. Mesentery of 33 rats was prepared for intravital microscopic study, and indexes of lymph propulsion (contraction frequency, stroke volume, and ejection fraction) were monitored. In 14 rats, total lymph flow was measured by cannulating the main intestinal lymph trunk. After a control period, lymph flow was increased by hemodilution with isotonic saline. Right atrial pressure did not significantly increase during the hemodilution period. Total lymph flow increased to approximately 25 times control. Lymph propulsion (the product of stroke volume and contraction frequency) decreased in five lymphangions (group I). In 22 lymphangions, lymph propulsion increased one to five times control (group II). The remaining six lymphangions increased lymph propulsion by greater than five times control (group III). Group I possessed the largest end-diastolic diameter, highest baseline contraction frequency, and did not dilate as lymphatic filling increased. Group III possessed the smallest initial end-diastolic diameter and lowest baseline contraction frequency, and end-diastolic diameter doubled as lymphatic filling increased. The characteristics of group II were between those of groups I and III. Total lymph flow and lymph propulsion by group III lymphangions tended to agree when lymph flow was less than five times control. In more edematous conditions, total lymph flow exceeded lymphatic pump flow. The characteristics of group II were between those of groups I and III. Analysis of the location of various sized lymphangions within the lymphatic network indicated that the smaller group III lymphangions were located nearer the intestinal wall, and the larger group I lymphangions were nearer the outflow from the mesentery.(ABSTRACT TRUNCATED AT 250 WORDS)

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Grevers, Gerhard. "Lymphangiom." HNO Nachrichten 44, no. 4 (July 30, 2014): 14. http://dx.doi.org/10.1007/s00060-014-0370-1.

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Yan, Xueqiang, Nannan Zheng, Xiaoli Xiong, Xufei Duan, Jun Yang, Hongqiang Bian, Zhenchuang Zhu, Xiaofeng Xiong, and Xuyong Chen. "The Roles of Neuropilin 2/VEGF-C Axis in a Series of Recurrent Lymphangioma." European Journal of Pediatric Surgery 30, no. 04 (April 23, 2019): 337–42. http://dx.doi.org/10.1055/s-0039-1687869.

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Introduction Vascular endothelial growth factor (VEGF) and its receptor act as a major contributor to lymphangioma, but their role on nonrecurrent and recurrent lymphangiomas remain unclear. We aim to investigate those factors in the generation of recurrent lymphangioma. Materials and Methods Patients diagnosed with lymphangioma from January 2005 to December 2012 in our hospital were collected and divided into nonrecurrent and recurrent lymphangiomas. The clinical characteristics including age, sex, symptoms, location, and size of lymphangioma were collected. Surgical resection samples were collected for histology, protein and mRNA detection of VEGF-C, VEGF receptor-3 (VEGFR-3), and neuropilin 2 (Nrp2). Follow-ups including lymphangioma recurrent and the local symptoms such as ulcer were reviewed. Results A total of 80 patients aged from 5 months to 12 years were enrolled in this study, 51 patients had no recurrence and other 29 patients suffered from recurrent lymphangioma. There was no significant difference in demographic data and clinical characters between the two groups (p > 0.05). Immunohistochemistry staining showed that VEGFR-3 remained unchanged between nonrecurrent and recurrent lymphangiomas (p > 0.05), and VEGF-C and Nrp2 were significantly increased in recurrent lymphangioma compared with nonrecurrent lymphangioma (p < 0.05). The same expression trend was proved as detected by protein and mRNA levels. Conclusion The VEGF-C/Nrp2 axis was significantly increased in the recurrent lymphangioma, indicating that VEGF-C/Nrp2 targeted therapy may serve as a potential therapeutic strategy for recurrent lymphangioma.

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Šileikis, Audrius, Donatas Danys, Gytis Žaldokas, and Kęstutis Strupas. "Abdominal lymphangiomas in adults: case report and literature review." Lietuvos chirurgija 14, no. 2 (January 1, 2015): 111–15. http://dx.doi.org/10.15388/lietchirur.2015.2.8250.

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Intraabdominal lymphangioma is rare and comprises 5% of all lymphangiomas. In adults, it is less common than in children, and because of a benign progress lymphangioma is usually asymptomatic and its diagnosis is quite difficult. However, it is recommended to extirpate lymphangioma surgically to avoid complications. There is the question if lymphangioma should be completely excised to avoid relapses. We present a case of cavernous lymphangioma in an adult male who underwent a partial resection of the tumour. After ten years of observation, there is no evidence of tumour recurrence.

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Taylor, Dustin, Natalie Kash, and Sirunya Silapunt. "A Supernumerary Nipple-Like Clinical Presentation of Lymphangioma Circumscriptum." Case Reports in Dermatological Medicine 2018 (2018): 1–3. http://dx.doi.org/10.1155/2018/6925105.

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Lymphangioma circumscriptum is a superficially localized variant of lymphangioma. The characteristic clinical presentation is a “frogspawn” grouping of vesicles or papulovesicles on the proximal limb or limb girdle areas. Though most lymphangiomas develop congenitally, the lymphangioma circumscriptum subtype is known to present in adults. We report a case of lymphangioma circumscriptum on the left inframammary area of an African American female with an unusual supernumerary nipple-like clinical presentation. Our patient presented with a firm, smooth, hypopigmented papule, and the clinical diagnosis of keloid was made initially. However, she returned reporting growth of the lesion and was noted to have a firm, exophytic, lobulated, pink to skin-colored nodule. Histopathological examination demonstrated dilated lymphatic vessels, consistent with the diagnosis of lymphangioma. The presentation as a firm, hypopigmented papule and later exophytic, lobulated, skin-colored nodule in our case represents a clinical presentation of lymphangioma circumscriptum not previously described in the literature. Correct diagnosis in lymphangioma circumscriptum is vital, as recurrence following surgical resection and secondary development of lymphangiosarcoma and squamous cell carcinoma following treatment with radiation have been reported. Thus, it is important to consider lymphangioma circumscriptum in the differential of similar lesions in the future to allow appropriate diagnosis, treatment, and monitoring.

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Rebbani, Mohammed, Yasser El Brahmi, Failsal El Mouhafid, Abdelmounaim Ait Ali, and Aziz Zentar. "Splenic cystic lymphangioma in adult: a case observed in the Visceral Surgery Department II of Mohamed V Military Hospital." International Surgery Journal 7, no. 9 (August 27, 2020): 3099. http://dx.doi.org/10.18203/2349-2902.isj20203802.

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Cyctic lymphangioma is a primary benign tumor due to congenital malformations of the lymphatic vessels. It is more often seen in pediatric patients and the usual site for lymphangioma is the cervical and axillary region. However, it is exceptionally seen in adults and involving rarely the spleen. The discovery of the splenic lymphangioma is generally accidental during imaging performed for another pathology. Indeed, being most often asymptomatic, the clinical presentation of cystic lymphangioma is polymorphic and it is related generally to mass effects. In this paper, we report the case of a 43 years old patient in whom the discovery was fortuitous during imaging for a non-specific symptomatology. The physical examination was normal and magnetic resonance imaging strongly evoked the diagnosis of cystic lymphangioma. A total splenectomy was performed and the histological examination has confirmed the positive diagnosis of splenic lymphangioma. Finally, this case confirmes that the diagnostic of splenic lymphangioma should be evoked in front of splenic cystic lesions and the confirmation and the differential diagnosis are made by histopathology and immunohistochemistry studies.

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Gendvilaitė, Neda, Julius Drachneris, and Tomas Poškus. "Lymphangioma of the Mesentery: Case Report and Review of the Literature." Acta medica Lituanica 28, no. 1 (May 14, 2021): 20. http://dx.doi.org/10.15388/amed.2021.28.1.20.

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Background: Lymphangioma of the mesentery is a rare benign condition. Lymphangioma usually occurs in children during first few years of life most likely because of congenital abnormality of the lymphatic system. It may also be caused by trauma, lymphatic obstruction, surgery, inflammatory process, or radiotherapy. Lymphangioma of the mesentery represents less than 1% of all lymphangiomas and about 70% of abdominal lymphangiomas.Case presentation: We report the case of the 42-year-old woman who was diagnosed with the lymphangioma. Laparotomy was performed. A cystic lymph-filled tumor of about 12 cm in diameter was removed from the ileum mesentery. Conclusions: Lymphangioma of the mesentery is a rare condition. Despite its benign nature, it can cause serious complications if not treated. Ultrasound and CT are used for detection of lymphangioma. It is important to surgically remove the lymphangiomas even in the absence of symptoms.

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Ahn, Jhii-Hyun. "Cystic Lymphangioma of the Ileum Causing Small Bowel Obstruction: A Case Report." Korean Journal of Abdominal Radiology 5, no. 1 (July 15, 2021): 81–83. http://dx.doi.org/10.52668/kjar.2021.00052.

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Cystic lymphangioma is a rare benign tumor containing chylous or serous fluid. The occurrence of cystic lymphangioma in the small bowel is known to be extremely rare. We would like to report a case of cystic lymphangioma that occurred in the small bowel and caused small bowel obstruction.

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Rao, T. Narayana, T. Parvathi, and A. Suvarchala. "Omental Lymphangioma in Adults—Rare Presentation Report of a Case." Case Reports in Surgery 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/629482.

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Lymphangioma is an uncommon benign lesion that usually occurs during childhood. Its occurrence in adults is rare. Its presentation in the abdomen is even rare. This case report describes a case of omental lymphangioma presented as retroperitoneal lump. Subsequent imaging, operative, and histological findings revealed omental lymphangioma. Laparotomy done under general anesthesia, a 10 × 12 cm cystic swelling arising from omentum, identified complete excision of the cyst done and send the specimen for histopathological examination. Biopsy report came as omental lymphangioma. Complete surgical excision is the treatment of choice. Prognosis is excellent and recurrence rate is very low if resection is complete. During two years of followup no recurrence was detected. Omental lymphangioma is very rare presentation among abdominal lymphangiomas specifically in adults. Complete excision is the treatment of choice. Long-term followup is required to detect recurrence.

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Tater, Jawaher M., Bashar H. Abdullah, and Wisam A. Hussain. "Immunohistochemical expression of endocan, as a marker of assessment of angiogenic potential in benign vascular lesions (hemangioma, lymphangioma and lobular capillary hemangioma) of head and neck region." Journal of Baghdad College of Dentistry 30, no. 4 (December 15, 2018): 61–64. http://dx.doi.org/10.26477/jbcd.v30i4.2556.

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BACKGROUND: Vascular tumors are a heterogeneous group of diseases with biological behavior ranging from a hamartomatous growth to frank malignant. The pathophysiology of lymphangioma, vascular malformation and hemangioma is interconnected, blood vessels known to be the site of origin of hamartomas, venous malformations and some neoplasms as benign, tumor-like growth of vessels (hemangiomas). Angiogenesis is the process of formation of new blood vessels from an existing structure. Aims of study Assessment of angiogenic potential in benign vascular lesions (hemangioma, lymphangioma and lobular capillary hemangioma) of head and neck region. Materials and Methods: Twenty-two formalin-fixed paraffin-embedded tissue blocks of Hemangioma/vascular malformation, thirty of lobular capillary hemangioma and another twenty of lymphangioma to be stained with Endothelial cell-Specific Molecule-1 (ESM-1) monoclonal antibody. Results: Microvessel density expressed by Endothelial cell-Specific Molecule-1 (ESM-1) immunomarker was found in all cases with mean density of (37.44±23.16) for lobular capillary hemangioma and (25.02±13.89) for hemangioma and (6.34±3.52) for lymphangioma. According to post hoc test ESM-1 marker expression showed a high significant difference between (hemangioma and lymphangioma=0.001), (lymphangioma, pyogenic granuloma=0.000), and it was significantly different between (hemangioma, pyogenic granuloma=0.011) Conclusions: The obvious capillary growth in lobular capillary hemangioma revealed that lobular capillary hemangioma showed the highest activity of angiogenic potential in comparison to hemangioma and lymphangioma.

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Nurmeev, I. N., M. A. Zykova, and L. M. Mirolubov. "Momentary radical removal of lymphangioma in children. The results of prospective cohort study in parallel groups." Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 64, no. 5 (November 16, 2019): 189–93. http://dx.doi.org/10.21508/1027-4065-2019-64-5-189-193.

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Lymphangioma is a benign neoplasm caused by a congenital malformation of the lymphatic vessels.Purpose. To study the possibility of momentary radical removal of lymphangioma in children based on a prospective cohort study in parallel groups.Characteristics of children and research methods. The article presents the results of treatment of 152 patients with lymphangioma, reported from the Department of Vascular Surgery of the Children’s Republican Clinical Hospital of Tatarstan. All patients were divided into 3 groups according to the applied method of treatment. The patients in Group 1 (n=95) underwent radical removal of lymphangioma, patients in Group 2 and Group 3 underwent partial removal followed by sclerotherapy of the residual cavity of the lymphangioma.Results. The authors observed relapse in 17 (11.2%) cases, 11 of these cases were observed after previous operation of complete excision (Group 1). According to the study of the distribution of relapses, there was no difference between the groups.Conclusion. Momentary radical excision of lymphangioma is implementable in 63.3% of cases. If it is impossible to remove lymphangioma completely they use partial excision and sclerotherapy of the residual cavity. The probability of relapse does not increase in case of impossibility to remove lymphangioma completely. Minimal invasive procedure is a priority of modern surgery, as it reduces surgical trauma, facilitates postoperative period and improves cosmetic result.

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Shukla, Samir, Rahul Shivhare, Vikas Lal, and Deepak Rathore. "Cystic lymphangioma of breast and axillary region in an adult: a rare presentation." International Surgery Journal 8, no. 1 (December 28, 2020): 391. http://dx.doi.org/10.18203/2349-2902.isj20205911.

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Cystic lymphangioma also known as cystic hygroma, is a congenital malformation of lymphatic system. Most lymphangioma are present at birth and are diagnosed by the age of 2 years. They are usually located in the head and neck region and are rare in other location. We are reporting a case of cystic lymphangioma in breast and axillary region in a 23 years old female. Physical examination revealed a non-tender cystic mass in axilla and upper outer quadrant of left breast. Ultrasonography (USG) revealed a hypoechoic mass lesion and magnetic resonance imaging (MRI) showed a multi-spectated cystic mass in left axilla closely involving the left breast parenchyma. Wide local excision was done and histopathological examination further confirmed the diagnosis of cystic lymphangioma. Although it is very rare, cystic lymphangioma should be considered in the differential diagnosis of mass in breast and axillary region.

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Ito, Eiji, Kiyoshi Saito, Tetsuya Nagatani, Masaaki Teranishi, Yuzuru Kamei, Shunjiro Yagi, Takashi Kawabe, Norihiro Niimi, and Jun Yoshida. "Lymphangioma of the skull base bones leading to cerebrospinal fluid rhinorrhea." Journal of Neurosurgery: Pediatrics 2, no. 4 (October 2008): 273–76. http://dx.doi.org/10.3171/ped.2008.2.10.276.

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Lymphangioma localized to the bones of the skull base is rare. The authors report herein the case of a 5-year-old boy who presented with lymphangioma of the bone, localized to the skull base and leading to cerebrospinal fluid (CSF) rhinorrhea with meningitis. Neuroimaging demonstrated lytic destruction with a cyst in the right middle skull base. The patient was successfully treated with resection of the tumor and prevention of CSF leakage. Histopathological examination revealed a lymphangioma. An enlarging lymphangioma can lead to bone destruction. A differential diagnosis of a lytic lesion for a cyst at the skull base is important for proper case management.

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Alsmady, MM, MA Aladaileh, K. Al-Zaben, MM Saleem, and O. Alimoglu. "Chylopericardium presenting as cardiac tamponade secondary to mediastinal lymphangioma." Annals of The Royal College of Surgeons of England 98, no. 8 (November 2016): e154-e156. http://dx.doi.org/10.1308/rcsann.2016.0203.

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Mediastinal lymphangioma is a rare entity and chylopericardium is a rare form of pericardial effusion. We report a case of acute chylous cardiac tamponade due to a cervicomediastinal lymphangioma in a one-year-old boy. A chest x-ray revealed marked cardiac enlargement and echocardiography showed massive pericardial effusion. Emergency surgery was performed whereby a pericardial window was created, followed by excision of the lymphangioma.

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Karaseva, Olga V., V. A. Kapustin, A. O. Agayants, A. L. Gorelik, and A. N. Kislyakov. "LYMPHANGIOMA AS A CAUSE OF ILEUS." Russian Journal of Pediatric Surgery 23, no. 2 (July 9, 2019): 91–94. http://dx.doi.org/10.18821/1560-9510-2019-23-2-91-94.

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Introduction. Lymphangiomas are mature benign tumors emanating from the lymphatic vessels making up 9-10% of all benign neoplasms in pediatric oncology. In our practice, we have encountered a rare complication of the lymphangioma of the abdominal cavity - an ileus Objective: To present a clinical picture, diagnostic and surgical tactics in a rare clinical observation of mesenteric lymphangioma, complicated by ileus. Material and methods. Boy aged of 6 years 4 months. He was taken to the emergency department of the Research Institute of NDHiT by an ambulance team (SMP) with suspected acute appendicitis 6 hours after the onset of the disease. Results. According to the results of clinical, laboratory and echographic examination, a child with a clinical picture of “acute abdomen” was suspected of an abdominal lymphangioma. For the purpose of the differential diagnosis of a complicated course of the lymphangioma of the abdominal cavity with complicated destructive appendicitis, 2 hours after hospitalization, laparoscopy was performed and there was confirmed lymphangioma of the ileum mesentery, complicated by the twisting of the latter. After elimination of the torsion, a section of the ileum with a tumor was resected with an end-to-end anastomosis. Histologically, the diagnosis of lymphangioma was confirmed. Conclusion. The cause of “acute abdomen” may be the development of complications of the mesenteric lymphangioma. Timely hospitalization of the child in a specialized hospital allows making a diagnosis in a timely manner, select the optimal surgical tactics and prevent life-giving complications

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Coutada, Rosalia S., Joao P. Silva, Domingos C. Ribeiro, and Paula M. Pinheiro. "Fetal axillary lymphangioma." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 5 (April 28, 2020): 2198. http://dx.doi.org/10.18203/2320-1770.ijrcog20201836.

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Lymphangioma is a rare congenital malformation of the lymphatic system that occur in 1 per 6000 live births. The most common site of lymphangioma is the neck (also named cystic hygroma), accounting for 75% of the cases, and it is strongly related to aneuploidies. Axillary location is very rare and appears not to be associated with chromosomal abnormalities. Tumor growth, fetal anemia secondary to intralesional bleeding, hydrops fetalis and shoulder dystocia are possible obstetric complications of this condition. The prognosis is generally good in the absence of abnormal karyotype, fetal hydrops or extension of the lymphangioma to adjacent tissues. Surgical excision or sclerotherapy are the main treatment choices. The authors present a case of a right fetal axillary lymphangioma and review the literature.

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Morgan, M., M. Bennett, and J. A. Wilson. "Cavernous lymphangioma in the adulat parotid." Journal of Laryngology & Otology 111, no. 6 (June 1997): 590–91. http://dx.doi.org/10.1017/s0022215100138010.

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AbstractCavernous lymphangioma is a benign congenital lesion that usually appears in childhood. It rarely presents in the adult but may be diagnosed at this late stage due to the slow growing nature of the tumour. It is rarely found i n the salivary glands and when it does occur, the gland is usually incorporated by lymphangioma of surrounding tissue.We present and discuss the case of a cavernous lymphangioma in the parotid gland of an adult male.

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Berry, Julie A., Jeffrey S. Wolf, and William C. Gray. "Squamous Cell Carcinoma Arising in a Lymphangioma of the Tongue." Otolaryngology–Head and Neck Surgery 127, no. 5 (November 2002): 458–60. http://dx.doi.org/10.1067/mhn.2002.128903.

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Lymphangioma of the tongue is a rare, benign malformation of the lymphatic channels. The clinical course is characterized by multiple recurrences after local excision. A review of the literature revealed no prior association of a head and neck lymphangioma with squamous cell carcinoma (SCC). We present the case of a 64-year-old woman with a history of a tongue base lymphangioma who developed a base of tongue SCC. Further confounding the pathophysiologic scenario was a history of nasopharyngeal irradiation for adenoid hypertrophy.

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Yagihashi, Yusuke, Keiji Kato, Kanji Nagahama, Masakazu Yamamoto, and Hiroshi Kanamaru. "A Case of Laparoscopic Excision of a Huge Retroperitoneal Cystic Lymphangioma." Case Reports in Urology 2011 (2011): 1–3. http://dx.doi.org/10.1155/2011/712520.

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Retroperitoneal cystic lymphangioma is a rare benign tumor. Most patients eventually experience some symptoms that necessitate therapeutic intervention. Excision is the treatment of choice, and some cases of laparoscopic resection have been reported. We report another case of a huge retroperitoneal cystic lymphangioma that was successfully excised laparoscopically with the SAND balloon catheter. Large cystic lymphangioma was downsized by puncturing and aspirated with the SAND balloon catheter. Laparoscopic surgical technique should be considered for treatment of selected cystic lesions of retroperitoneal origin.

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Bae, Jae-Moon, Ho Seong Han, and Young-Woo Kim. "Lymphangioma." Ewha Medical Journal 19, no. 2 (1996): 199. http://dx.doi.org/10.12771/emj.1996.19.2.199.

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Thompson, Lester D. R. "Lymphangioma." Ear, Nose & Throat Journal 85, no. 1 (January 2006): 18–19. http://dx.doi.org/10.1177/014556130608500106.

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Chaudhary, Santosh, Aashish Raj Pant, and Badri Prasad Badhu. "Managing Recurrent Orbital Lymphangioma in a Pubertal Female with Negative Pressure Aspiration and Intralesional Bleomycin Injection: A Case Report." Nepalese Journal of Ophthalmology 13, no. 1 (January 1, 2021): 157–61. http://dx.doi.org/10.3126/nepjoph.v13i1.30723.

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Introduction: Management of orbital lymphangioma is challenging. Complete surgical excision is often impossible due to its infiltrative nature. Sclerosing agents have been used in its management with variable outcomes. We report a case of recurrent orbital lymphangioma managed with intralesional bleomycin. Case: A 14-year-old female presented with proptosis of the right eye for two weeks. She had a similar history at five years of age for which she underwent surgical excision. We performed negative pressure aspiration using a 20-gauge angiocatheter, injected bleomycin, and left the cannula in situ for repeat aspiration to maintain cyst collapse. Observation: The lymphangioma regressed, and there was no recurrence at six months of follow-up. Conclusion: This report highlights the use of negative pressure aspiration and intralesional bleomycin injection by minimal intervention using angiocatheter in the successful management of orbital lymphangioma.

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Meichtry, S., and T. Mantei. "Lymphangiom der Zunge." Laryngo-Rhino-Otologie 94, no. 10 (July 2, 2015): 692–94. http://dx.doi.org/10.1055/s-0035-1550038.

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Rohrbach, Jens, Thomas-Michael Wohlrab, and Karina Küper. "Lymphangiom der Bindehaut." Klinische Monatsblätter für Augenheilkunde 211, no. 09 (September 1997): 211–12. http://dx.doi.org/10.1055/s-2008-1035123.

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Journal articles on the topic 'Lymphangion'

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