Milky Spots in the Greater Omentum

Abstract

The article presents a review of data from foreign and domestic literature focusing on various aspects of the morphology and functions of the milky spots of the greater omentum in the health and in the pathological process in the abdominal cavity. The milk spots of the greater omentum do not have a capsule; the cellular composition is normally represented in the majority by macrophages and lymphocytes. However, in pathological conditions within the abdominal cavity, additional cells such as fibroblasts, plasmocytes, dendritic (antigen-presenting) cells, and mast cells are detected in the milky spot.
 Normally, in the structure of the milky spot there are fat cells (adipocytes), undifferentiated mesenchymal cells, elastic, reticular and nerve fibres. A thorough analysis of existing literature has revealed the dual role of milky spots, encompassing both protective and immune functions.
 The protective role involves the mobilization of resident macrophages from the milky spot into the abdominal cavity in response to the presence of pathogens. During the initial stages of the inflammatory response, mesothelial cells, when activated by pathogens, release chemokines that intensify inflammation. This process creates a gradient of chemotactic cytokines, enabling the migration of leukocytes from fenestrated postcapillary venules through the stigmata and into the abdominal cavity. The immune role is characterized by the secretion of cytokines by mature dendritic (antigen-presenting) cells and their interaction with milky spot T cells to achieve an immune response. Milky spot macrophages secrete chemokine ligands that promote the migration and colonization of ovarian cancer cells within the greater omentum.