Changes in Paracardiac Lymph Nodes in Portal Hypertension

Abstract

Because of their proximity to the coronary vein and thoracic duct, the paracardiac lymph nodes are liable to develop both venous and lymphatic congestion. The authors studied morphologic changes in the paracardiac lymph nodes in patients with portal hypertension.Paracardiac lymph nodes were obtained during surgery from 40 volunteer patients with esophageal varices due to schistosomal portal hypertension (29 nonbleeders, 11 bleeders). Paracardiac lymph nodes from 10 volunteer patients having surgery for correction of incisional hernia served as controls.The main histologic difference found in this study was the lower incidence of necrosis in nonbleeders. This indicates the possible role played by inadequate lymphatic drainage of the excessive lymph produced by the congested varicesbearing area in the bleeder.

Lymphoscintigraphic Findings as Indicators of Lymphaticovenous Anastomosis Outcome in Patients With Extremity Lymphedema

“…This is consistent with a previous report that found dermal backflow is significantly correlated with improved clinical result in patients with LVA 4 . Some studies have found evidence of peripheral lymphovenous communications 23–26 . They were found in patients with lymphedema, in patients with lymph nodes involved by malignant disease, and in patients who had had a surgical interruption of lymphatic pathways, either vessels or nodes 23 .…”

“…4 Some studies have found evidence of peripheral lymphovenous communications. [23][24][25][26] They were found in patients with lymphedema, in patients with lymph nodes involved by malignant disease, and in patients who had had a surgical interruption of lymphatic pathways, either vessels or nodes. 23 Aboul-Enein et al 24 have demonstrated the existence of lymphovenous communications in the arms of women who escaped arm swelling after breast cancer treatment, but not in those who developed breast cancer-related lymphedema, or normal controls, through direct intralymphatic injection of labeled albumin and both ipsilateral and contralateral venous blood sampling.…”

“…[23][24][25][26] They were found in patients with lymphedema, in patients with lymph nodes involved by malignant disease, and in patients who had had a surgical interruption of lymphatic pathways, either vessels or nodes. 23 Aboul-Enein et al 24 have demonstrated the existence of lymphovenous communications in the arms of women who escaped arm swelling after breast cancer treatment, but not in those who developed breast cancer-related lymphedema, or normal controls, through direct intralymphatic injection of labeled albumin and both ipsilateral and contralateral venous blood sampling. Another study has suggested that the presence or postsurgical opening up of lymphovenous communications may be a protective factor for approximately 75% of patients with breast cancer who do not develop lymphedema after breast surgery.…”

Development of Lymphatic Vessels: Tumour Lymphangiogenesis and Lymphatic Invasion

“…Functional lympho-venous anastomoses have been observed in women, who underwent axillary lymphnodoectomy in the course of radical mastectomy. Such anastomoses seem to be beneficial and prevent edema formation in the operated arm [11]. Mice that lack either the protein-tyrosine kinase Syk or its adapter protein SLP-76 develop abnormal arterio-venous and lympho-venous connections, resulting in extensive haemorrhage into the cutaneous lymphatic vasculature [12], however, the intracellular signalling cascades have remained unknown yet.…”