Exploring the mesenteric lymphatic apparatus: A morphological and immunohistochemical investigation with clinical correlations.

Modern immunohistochemical techniques allow a detailed study of the lymphatic system in many organs and areas of the body. We performed an in-depth study on lymphatic vessels of the ileal and colonic mesenteries, together with the greater omentum where they appear particularly numerous and mainly represented by capillaries interconnected among themselves and with lymph nodes. The capillary wall consists of a fine single sheath of endothelial cells wrapped around by a subtle collagen membrane and deprived of valves. The progression of lymph flow is promoted by external forces acting on the capillary walls. Only at the mesenteric roots can pre- and post-lymph nodal collector vessels be observed. Our observations help to explain different patho-physiological correlations and the possible presence of skip lymph node metastases.

[1]  Jorge A. Castorena‐Gonzalez,et al.  Lymphatic pumping: mechanics, mechanisms and malfunction , 2016, The Journal of physiology.

[2]  Y. Iwakiri The lymphatic system: A new frontier in hepatology , 2016, Hepatology.

[3]  K. Matzel,et al.  Prognosis of patients with colonic carcinoma before, during and after implementation of complete mesocolic excision , 2016, The British journal of surgery.

[4]  N. Harvey,et al.  The lymphatic vasculature: development and role in shaping immunity , 2016, Immunological reviews.

[5]  F. Piscioli,et al.  Surgicopathologic correlations regarding lymphatics in hilar cholangiocarcinoma. , 2016, Surgery.

[6]  B. Lahrmann,et al.  Quantitative Histomorphometry of the Healthy Peritoneum , 2016, Scientific Reports.

[7]  A. Manenti,et al.  For a clearer comprehension of the lymphatic system in perihilar cholangiocarcinoma. , 2016, American journal of surgery.

[8]  G. Barbolini,et al.  The role of lymphatics in portal biliopathy. , 2016, Journal of visceral surgery.

[9]  M. Stringer,et al.  Mesocolic Lymph Node Number, Size, and Density: An Anatomical Study , 2015, Diseases of the colon and rectum.

[10]  S. Chakraborty,et al.  Emerging trends in the pathophysiology of lymphatic contractile function. , 2015, Seminars in cell & developmental biology.

[11]  G. Barbolini,et al.  New advances on placental hydrops and related villous lymphatics. , 2015, Lymphology.

[12]  R. Stewart,et al.  Adaptation of mesenteric lymphatic vessels to prolonged changes in transmural pressure. , 2013, American journal of physiology. Heart and circulatory physiology.

[13]  Y. Iwakiri,et al.  The lymphatic vascular system in liver diseases: its role in ascites formation , 2013, Clinical and molecular hepatology.

[14]  A. Nocito,et al.  Atraumatic chylous ascites: systematic review on symptoms and causes. , 2011, Journal of the American College of Surgeons.

[15]  D. Zawieja,et al.  Determinants of valve gating in collecting lymphatic vessels from rat mesentery. , 2011, American journal of physiology. Heart and circulatory physiology.

[16]  A. Gashev Basic mechanisms controlling lymph transport in the mesenteric lymphatic net , 2010, Annals of the New York Academy of Sciences.

[17]  Y. Ohtani,et al.  Organization and developmental aspects of lymphatic vessels. , 2008, Archives of histology and cytology.

[18]  Anatoliy A Gashev,et al.  Lymphatic Vessels: Pressure‐ and Flow‐dependent Regulatory Reactions , 2008, Annals of the New York Academy of Sciences.

[19]  A. Venugopal,et al.  Lymphangion coordination minimally affects mean flow in lymphatic vessels. , 2007, American journal of physiology. Heart and circulatory physiology.

[20]  David C Zawieja,et al.  Lymphatic smooth muscle: the motor unit of lymph drainage. , 2004, The international journal of biochemistry & cell biology.

[21]  H. Shimoda,et al.  Enzyme-histochemical demonstration of the intramural lymphatic network in the monkey jejunum. , 1997, Archives of histology and cytology.

[22]  R. Miyauchi,et al.  Structural organization of the initial lymphatics in the monkey mesentery and intestinal wall as revealed by an enzyme-histochemical method. , 1993, Archives of histology and cytology.

[23]  A. Manenti,et al.  Immunohistochemical improvement in the analysis of the lymphatic metastases from lung carcinoma. , 2014, Annals of Thoracic Surgery.