Journals at the University of Arizona
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Injuries and Complications of the Lymphatic System Following Renal Transplantation
No full textAlthough major lymph trunks of the recipient are transected during renal transplantation, nolymphat ic complicat ions per se have been reported. We believe that these complicat ions a re notinfrequent but have not been recognized as sud1 because no lymphograms were performed. Thisreport deals with fou r patients who developed draining sinuses, pelvic abscesses and other massesin whom the correct diagnos is was established by lymphography; nam ely, that the complicationswere caused by continuous lymphatic drainage from lymphatic vessels.The purpose of this paper is to describe four patients who underwent renal transplantationand developed complications directly r elated to surgical injury of pelviclymph vessels. Review of the literature reveals a great variety of possible post-operative( 1, i , 9) complications which may develop after renal transplantation, but relationshipof such complications to the lymphatic system has rarely been stressed ( 4, 8). This isparticularly surprising since the surgery needed for the placement of a transplantedkidney requires transection of major lymphati cs of the external iliac chain. During thepreparation of the vascular pedicle the lymphatic and aureolar ti ssue surrounding theexternal iliac and hypogastric vessel must be excised. Failure to identify and ligate suchvessels may result in post-operative leakage into potential pelvic spaces. Lymphographycorrectly established the relationships of draining sinuses and/or pelvic masses whichdeveloped in four patients who underwent renal transplantation . Brief histories of thes
Lymphangiography in Lymphangiomatosis of Bone
No full textradiographs are essential to demonstrate the intraosseous localization of the contrast material.Lymphangiomatosis of bone seems to be due to lymphatic dysplasia with valvular insufficiency andhas therefore to be considered as a cong1mital malformation.Lymphangiomatosis of bone has first been described as an entity by Bickel and Brodersin 1947. Haas and Reichelt (2) reported a family consisting of several blood relativeswith evidence of lymphangiomatosis of bone. However, lymphographic investigationshave been published in only four cases. Kittredge et al. (3) presented the case of a fifteen-year-old boy with a lymphadenopathy in the left groin, but no lymphedema. Theplain roentgenograms showed multiple osteolytic lesions in the pelvis, hip and shoulder.Histologically the defects were caused by dilated lymphchannels. The lymphogramsshowed a disorganization of the lymphatic vessels in the thigh and pelvis, but the contrastmaterial did not enter the bone lesions.Najman et al. ( 4) described a boy with a lymphangioma in the inguinal region accompaniedby lymphedema. Lytic bone lesions were found in the pelvis, limbs, chest andthe skull. Lower extremity lymphography showed dilated lyphatics, but no contrastmedium was located in the bone. Contrast material was injected into a bone cyst ofthe skull from where it passed into adjoining cystic lesions.Steiner et al. (6) performed a lower extremity lymphography on a boy with pleuraleffusion and lytic bone defects in the humerus and the bony structures of the kneejoints, but no lymphedema. Abnormal lymphatic vessels in the mediastinum and thoracicwall were demonstrated by lymphography. Although no contrast filling of thelytic bone lesions was obtained, the histological examination confirmed the presenceof abnormal lymphatic channels in the bone.Recently Nixon (5) demonstrated bone lymphangiomatosis lymphographically in a boywith lymphedema and osteolytic lesions in the femur and tibia. Contrast material wasfound within a cortical lesion of the femur 48 h following lymphography
THE ROLE OF LYMPH NODES IN PANCREATIC EDEMA
No full textThe pressure in the afferent lymphatic of the in situ perfused peripancreatic (periportal) lymph node of dogs rises with the rate of fluid infusion. A 10 min infusion of 500 ml physiological saline into the superior pancreato-duodenal artery resulted in gross ·edema of the pancreas. The lymph flow from the cannulated pancreato-duodenal lymphatic and the pressure in the non-transected pancreato-duodenal lymphatics increased. The rise in pancreato-duodenal lymphatic pressure during the intra-arterial infusion was in excess of that observed in either the thoracic duct or the internal jugular vein. Resistance at the peripancreatic lymph nodes to pancreato-duodenal lymph flow may thus be a significant contributing factor in the development of pancreatic edema.The significance of prelymphatic insufficiency of the intrapancreatic interstitial fluid movement in the development of pancreatic edema is discussed
EXPERIMENTAL STUDIES ON LYMPHATIC DRAINAGE OF THE PERITONEAL CAVITY USING 198AU-COLLOID*
No full textThe lymphatic drainage from the peritoneal cavity was studied scintigraphically and by determination of the specific accumulation of 198Au-colloid and of the 198Au -contents within the regional lymphatics, liver and spleen following intraperitoneal injection of 25 µCi in 29 rabbits. The investigationRevealed the selective 198Au-accumulation in the mediastinal lymph nodes and within the lymphatics of the greater momentum, whose absorptive capacity was shown to be significant. The theoretical background for visualization of the mediastinal lymph nodes scintigraphically and for the transposition of the greater momentum in the treatment of lymphedema was explained by these results. Moreover, it was previously suggested, that intraperitoneal radiotherapy affects the regional lymphatic system of the peritoneal cavity as well. The lack of radioactivity in the mesenteric lymph nodes and in the thymus indicated, that these organs do not participate in the lymphatic drainage mechanism of the peritoneal cavity
PASSAGE THROUGH THE LYMPH NODE. STUDIES WITH WATERED AND OILED CONTRAST MEDIUM GIVEN INTO AN AFFERENT LYMPHATIC
No full textThe authors investigated the passage of watered andoiled contrast media through the lymph node. PatentBlue dye diluted in saline has delineated as a ruleonly a circumscript area of the lymph node accordingto the supplying area of the afferent cannulated.Lipiodol Ultrafluid has been found suitable forfilling up the whole node: at first only a small partof the node became filled primarily from theafferent, while other parts were filled secondarilyfrom the hilus. The compartmentalisation of thelymph node has been proved by autoradiography(3H-thymidine), too
PARACORTICAL POST-CAPILLARY VENULES OF HUMAN LYMPH NODES WITH SPECIAL REFERENCE TO THE DISTRIBUTION OF THEIR ENDOTHELIAL IgG
No full textThe distribution of lgG in the endothelium of theparacortical post-capillary venules (PCV) of humanlymph nodes was studied in frozen sections byusing an indirect immunoperoxidase technique.Three different patterns of distribution could bedifferentiated (luminal site, intraendothelial andbasement membrane site). Each of these patternswas characteristically encountered in associationwith one of three grades of PCV (graded on thebasis of the height of their endothelial cells). Thesignificance of this close relationship between theIgG distribution and the changes in PCV endotheliumwas discussed in regard to the T-lymphocyterecirculation. A hypothesis was • introduceddescribing the possible sequence of events involvedin the traversing of T-lymphocyte through the PCVendothelium
TISSUE FLUID AND PERIPHERAL LYMPH--PHYSIOLOGICAL AND CLINICAL STUDIES APPLIED TO ONCOLOGY
No full textSymposium May 8-10, 1978, held at Norsk Hydro's Institute for Cancer ResearchThe Norwegian Radium Hospital, Oslo, Norwa
C1q-BINDING SUBSTANCES IN PERIPHERAL LYMPH IN BRONCHIAL CARCINOMA
No full textPeripheral leg lymph has been studied for the presenceOf C1q-binding substances by the 1251-C1q bindingradioassay in six male patients with untreated bronchialcarcinoma. In serum, this assay is highly specificfor antigen-antibody complexes (immune complexes).Three of the patients had immune complexesin serum, and they all also had C1q-binding substancesin peripheral lymph. The C1q-binding activitywas quite similar in serum and peripheral lymph. Inthe other three patients, immune complexes were notfound in serum, but in ·one of them, moderate amountsof C1q-binding substances were found in peripherallymph. The results suggest that immune complexesmay be found in peripheral lymph in cancer patientsin about the same amounts as in serum. However,formal proof is lacking that the C1q-binding substancesof peripheral lymph are real immune complexes
CELLS IN PERIPHERAL LEG LYMPH OF NORMAL MEN
No full textThe cells of human peripheral lymph collected fromleg lymphatic of healthy volunteers have been studiedby light- and electron microscopy. More than80% of the cells were lymphocytes. The rest of thecells were neutrophils, monocytes, phagocytes, intermediateforms between lymphocytes and monocytes,erythrocytes and large cells. Ultrastructurally theselarge cells had many features in common with theLangerhans cells of normal human epidermis andmay represent this cell type or a closely related one