Roentgenologic investigation of collateral lymphatic pathways after ligation of the thoracic duct

In 80 Wistar rats by means of electroroentgenolymphography lymphatic pathways and thoracic duct have been studied, normal and after ligation of the latter in 1-3 days, 1 and 2-3 months. Contrasting of the thoracic duct in the control animals reveals its additional ducts, that run in parallel to the main collector and they get into it after a certain distance, as well as different time phases of filling the duct are noted. When the thoracic duct is ligated, in 1-3 days dilatation of the ductal cistern, contrasting of lymphatic vessels and nodes in other regions are observed. In 1 month of the experiment the thoracic duct cistern is poorly expressed in comparison with the early time. The contrast substance continues to get into the group of the lymph nodes in other regions. A network of anastomoses of lymphatic vessels is formed in the area of ligation. In 2-3 months, when the contrast substance continues to get retrogradely into other groups and regions of the lymph nodes, final restoration of the lymph-flow takes place at the expense of formation of collateral pathways.     

Growth of the jugular lymph sacs and establishment of the topography of the cervical portion of the thoracic duct during early human ontogenesis

In 196 human embryos, prefetuses, fetuses and newborns, by means of a complex of morphological methods, development of the jugular lymphatic sacs and the process of settling of the thoracic duct cervical part topography have been studied. The jugular lymphatic sac anlages take place on the 6th week of the development. From the lymphatic cleft, situating in the mesenchyme near the anterior cardinal veins, multichambered cavities laid with endotheliocytes are forming,--the jugular lymphatic sacs. Connection of the initially close lymphatic sacs with the venous system takes place secondarily by the end of the embryonic period of development. In the area of the sac ostia a valve is formed, that makes morphological premises for unidirected lymph flow into the venous system. The lymph nodes developing at the place of the reducing jugular lymphatic sacs, ensure formation: from the left jugular lymphatic sac--the cervical part of the thoracic duct, from the right jugular lymphatic sac--the right lymphatic duct and the jugular and the subclavicular lymphatic trunks. Variability in the form and topography of these structures are determined both by the form and construction of the jugular lymphatic sacs and by developmental peculiarities of the lymph nodes at their place. The process of settling of the thoracic duct cervical part topography depends on age changes of its size and form, as well as on development of structures situating nearby, and by the time of birth it is not completed.     

Catecholamines in adrenergic nerve fibers of the lymph nodes after sympathectomy

Using Falck method in combination with microfluorimetry, catecholamine level in adrenergic nervous fibers has been measured in the canine popliteal lymph nodes, normal and in 12 h, 7, 30, and 90 days after unilateral lumbar sympathectomy. During first 24 h after the operation the level of catecholamines is for certain increased in the nervous fibers of the lymph node of the sympathectomized extremity. In 30 days after the sympathectomy their content drops at the side of the operation and increases in the contralateral extremity. By 3 months the equilibrium of the catecholamine content is restored in the nervous fibers of the lymph nodes in the homo- and contralateral extremities at the level higher than in the control. A conclusion is made that under conditions of unilateral sympathectomy only a partial sympathectomy of the popliteal lymph node is reached. All luminiscent adrenergic nervous fibers of the sympathectomized lymph node are processes of neurons, situating in the contralateral sympathetic trunk, or neurites of cells in sacral nodes, getting their preganglionic fibers from the contralateral trunk. The changes in catecholamine concentrations mentioned are considered as a compensatory reaction, directed to maintenance of general homeostatic equilibrium under conditions, when the nervous system transfers to a new level, ensuring the partly desympathized tissue by mediators.     

Characteristics of the regional lymphatic system of the external genitals in dogs in experimental studies

In the experiment performed on 80 mongrel female dogs by means of morphological and roentgenographical methods the structure of the lymphatic bed, pathways of lymph outflow and localization of the regional lymph nodes of the external genitals have been studied in the norm, at inflammation and at malignant tumors. Normal lymph outflow (53 animals) from the external genitals occurs via direct, cross and roundabout pathways. The regional nodes of the I order are inguinal lymph nodes and all the pelvic nodes, anorectal ones including. A part of vessels, without getting the lymph nodes mentioned, get into the retrosternal, caudal lumbar lymph nodes and the lumbar trunk. The cross of the lymphatic pathways occurs via the anterior, posterior commissures, at the level of the inguinal lymph nodes and within the limits of the pelvis. At an acute inflammation (24 animals) besides those mentioned above, roundabout vessels in the middle third of the femur are constantly revealed. They get into the femoral collector, and the vessels in the inferior third of the femur come into the popliteal lymph nodes. At malignant tumors of the external genitals (3 animals), besides all the pathways of the lymph outflow mentioned above, the femoral-crural roundabout pathway appears, it is connected with the lymphatic collector of the crus. Some vessels of the external genitals, combining with the vessels of the vagina, urethra and urinary bladder, get into the lumbar trunk and into the caudal lumbar lymph nodes. Increasing amount of all groups of the lymph nodes is noted.(ABSTRACT TRUNCATED AT 250 WORDS)     

Applied aspects of anatomy of the lumbar lymph nodes and their vessels

Using anatomical and roentgenoanatomical methods in 132 corpses of persons (from newborns up to 83 years of age) the anatomy of the lumbar lymph nodes and their vessels has been studied. Their topography, skeletotopy , amount, dimensions and form have been determined. Afferent and deferent lymphatic vessels in various groups of the lumbar lymph nodes, collateral pathways of lymph outflow to by-pass the lumbar lymph nodes are described. Certain data on the types of the thoracic duct formation are presented.     

Extra-organic lymphatic vessels and regional lymph nodes of the kidneys in dogs

An anatomical investigation of extraorganic lymphatic vessels and regional renal lymph nodes has been performed in 70 dogs. The regional lymph nodes in the right kidney are stated to be quantitatively constant, as well as cranial and caudal lateroaortal lymph nodes in the left kidney in regard to the middle left lateroaortal nodes, that get lymph from the left kidney parenchyma. One middle left lateroaortal lymph node is found in 47 animals examined, two lymph nodes--in 17 animals. In 6 cases a lymphatic vessel, that gets lymph from the renal parenchyma and independently runs into the cistern of the thoracic duct is found for the first time. The variant revealed is an exception from the rule known in lymphology: lymph in its way from periphery to the central collector runs, at least, through one lymph node.     

Lymph node topography and various features of the metastasis of malignant kidney tumors

Due to investigations of 102 renal preparations performed on corpses of mature persons, topographic peculiarities of the lymph nodes, getting lymph from the left and right kidneys, are revealed. Every lymph node of the left kidney gets greater amount of lymphatic vessels than every node of the right kidney. The lymph, running from the right kidney, usually gets through a less number of the subsequently arranged nodes up to the thoracic duct, as compared to the lymph, that runs from the left kidney. A typical position for the node, which the renal lymphatic vessels get into, is the fatty tissue in the area of the angle formed by the aorta edge and the inferior wall of the corresponding renal artery. The lymphatic nodes of the right kidney are arranged in the fatty tissue more compact than the left ones. These peculiarities, revealed by morphological investigations, are proved by analysis of 114 case histories of persons suffering from malignant neoplasms in the kidneys.     

Anlage of the initial part of the thoracic duct in human embryogenesis]

Canalization of the jugular lymphatic sac is accompanied with disengagement from the blood stream of the thoracic subcardinal and the thoracic parts of the superior mesocardinal veins, forming the paired thoracic anlage of the thoracic duct (ThD). Canalization of the retroperitoneal lymphatic sac (RLS) is combined with differentiation of the antevertebral plexus of the abdominal veins, formation of the ThD cistern. Lateroaortal, retrocaval and retroaortal lumbar trunks (LT) become its roots. Together with RLS and the ThD cistern they form the lymphatic "muff" around the abdominal aorta and inferior vena cava. The degree of its parts separation and its substitution by collaterals of LT and by lymph nodes determines the variants of the definitive organization of the ThD initial part. Already at the stage of anlage the intestinal trunk is not included in the ThD root system, but serves as the RLS anterior tributary, or its lumbar, preaortic tributary.     

Analysis of nerve supply pattern in thoracic duct in young and elderly men

BACKGROUND: Analysis of the innervation pattern of the thoracic duct in young and elderly human subjects has been performed. The subdivision of the vessels in cervical and lumbar region were taken in consideration. MeTHODS AND RESULTS: Immunostaining for general nerve fibers with a PGP 9.5 marker disclosed a diffuse innervation of the thoracic duct in young subjects, which was strongly reduced in elderly subjects. In young subjects, tyrosine hydroxylase (TH) and neuropeptide Y (NPY) immunoreactive fibers, markers of noradrenergic postganglionic sympathetic fibers, were frequent; choline acetyltransferase (ChAT) immunoreactive fibers, marker of cholinergic parasympathetic nerve fibers, were also well represented. Therefore, the influence of sympathetic and parasympathetic nerve systems on the thoracic duct can be confirmed. The immunoreactivity of vasoactive intestinal peptide (VIP), a neuropeptide frequently present in cholinergic parasympathetic nerve fibers, was scarcely present. Dopamine-positive fibers were observed in few short nerve fibers. Substance P (SP)-positive fibers were widely distributed in the medial and intimal smooth muscle layers, suggesting their involvement as contractile modulating fibers and sensitive fibers. In elderly subjects, an evident reduction of all specific nerve fibers analyzed was detected, the ChAT-positive fibers being the most affected. CONCLUSIONS: The lymphatic vessel thoracic duct is able to regulate hydrodynamic lymph flow by intrinsic contraction of its smooth muscle layer. Therefore, analysis of the thoracic duct innervation pattern may be important in assessing the regulation of vessel contraction. These findings called attention to the reduction of lymphatic drainage functionality affecting fluid balance in the elderly.     

Development of the thoracic duct in the prenatal period of human ontogeny

In 40 series of histological sections performed in human embryos and prefetuses from 4 up to 20 weeks of development, as well as in 20 corpses of fetuses and stillborns, it has been stated that the anlage of the thoracic duct appear in 6-7-week-old fetuses as lymphatic clefts surrounded with mesenchymal cells that are situated near large veins in the areas of the most active morphogenesis. Connecting with each other, the clefts form the jugular and retroperitoneal lymph sacs and a well branching network of canals. From the latter, on the 7th-8th week of development a plexus of lymph vessels appear, and later on (on the 8th-9th week)--bilaterally situating trunks of the thoracic duct. Further development of the thoracic duct is connected with the lymph nodes formation, their germs appear on the 9th-10th week along the course of the left trunk, as well as along the ductal branches and anastomoses. The formation of the lymph nodes results in reduction of some trunks and plexuses of the thoracic duct. Owing to this, its form in 14-15-week-old prefetuses resembles the one in newborns. Disturbances in the formation processes of the lymph nodes along the course of the reducing ductal areas, as well as their formation along the course of its main trunk can result in various structural variants of the thoracic duct in children and grown-up persons. Histogenesis of the thoracic duct wall and formation of the lymph nodes are not completed by birth.     

Anatomy of lymph nodes situated adjacent to the axilla in adult humans]

In 50 right and 50 left upper extremities examined in adult persons of both sex at the age of 28-90 years, delto-thoracic lymph nodes were revealed in 30% (right) and in 22% (left), and interthoracic lymph nodes--in 6% (right) and in 12% (left). The lymph nodes in question were revealed by the method of section after interstitial injection of Gerota's blue intradermally to fingers, palm, back of the hand deltoid area, lateral thoracic surface (at the level of the 6th intercostal space) and to the external part of the mammary gland. Injection was also performed into lymphatic vessels revealed by means of the interstitial injection. The delto-thoracic nodes were stated to situate in both the delto-thoracic sulcus and the delto-thoracic triangle. These vessels are situated along the course of the lateral collector of the free upper extremity. Deferent vessels of the delto-thoracic nodes flow into the apical axillary lymph nodes, into the deep and superficial cervical nodes, into the interthoracic lymph nodes and also into the subclavicular or into the jugular vein near a corresponding venous angle. Interthoracic lymph nodes, situated between musculus pectoralis major and minor, get their lymphatic vessels from lateral, inferior and central axillary nodes, from delto-thoracic nodes and also those lymphatic vessels that go from the mammary gland area. Deferent vessels of the interthoracic nodes flow into the apical axillary nodes.     

Freezing of rat lymphocytes. 2. Distribution and circulation of frozen-thawed 51Cr-labelled cells

Radioactive labelled synegenic fresh and frozen-thawed rat lymphoid cells were injected into groups of animals and their distribution in liver, spleen, lung, lymph nodes, and thoracic duct recorded. Principally the same pattern of distribution was demonstrated after injection of both fresh and frozen-thawed cells. However, more radioactivity was recovered from the liver and less from lymph nodes and thoracic ducts in recipients of frozen-thawed than of fresh cell preparations. This is caused by some damage to the cells in the freeze-thaw process.     

The lymphatic bed of the liver in man and animal and its transformation in disordered bile outflow

The lymphatic bed has been studied in 141 hepatic preparations of the man, dog and white rat. Development of obturation in the common bile duct in the man and at modelling a similar process in the animals results in essential morphological adaptive-compensatory and destructive changes in the hepatic lymphatic bed. The adaptive-compensatory reconstruction is especially well seen at initial stages of the disease. It is manifested as a total dilatation of the bed, certain reserve elements get into work, the bed capacity increases. Then certain new structural units of the bed, collateral pathways develop. When the obturational process lasts long, certain destructive changes of the hepatic lymphatic bed elements take place. The change in the relief of endotheliocytes is their most characteristic sign. With increasing age of the patients the degree of the destructive rearrangements of the hepatic lymphatic bed increases. In the experiment carried out on the animals the lymphatic outflow from the thoracic duct is determined, being an indirect index of the hepatic lymph-forming function. An essential increase of the lymph volume, several times greater than in the control, gets from the duct into the venous bed. A connection is revealed between the morphological transformations of the bed components and its drainage function. The lymphatic bed of the liver performs also an active work concerning resorption and transport of bilirubin, its content in the organ rather increases, when the common bile duct is obturated.     

Topography of lymphatic collectors and regional lymph nodes of the canine heart and their morphological characteristics

In 40 dogs lymphatic vessels and regional lymph nodes of the heart have been prepared. Morphology of the regional lymph nodes have been studied by means of various histological techniques. Lymph outflow from the canine ventricles is realized by three (less often), or by two (more often) collectors. In very rare cases one collector is formed. From the right atrium lymph flows out in two collectors (cranial and left). Lymphatic vessels of the left atrium get into the left collector of the ventricles, or into the tracheobronchial lymph nodes. Into the same nodes gets the lymphatic vessel, forming at the border of the left and right atrii. Cranial, medial, caudal mediastinal nodes (lymphatic mediastinal system) and right, middle and left tracheobronchial lymph nodes (tracheobronchial system) are regional lymph nodes of the canine heart. In the lymph nodes of the tracheobronchial system of puppies older than one month presence of exogenic pigment and signs of fibrous degeneration of parenchyma are noted.     

Mechanical characteristics of the canine thoracic duct: what are the driving forces of the lymph flow?

This study is designed to better understand the mode of lymph transport, particularly through the extrinsic pumping by external compression of the lymph vessel. The pressure-diameter relationship of lymphatic segments isolated from the canine thoracic duct was examined using a laser optical micrometer measurement system. Results revealed that the thoracic duct displayed a high extensibility or compliance in the physiological pressure range, yet became progressively less so with increasing internal pressure. The calculated incremental circumferential modulus of the thoracic duct under physiological pressure (range of 2 to 6 cm H2O) showed values ranging from 1.2 x 10(4) to 3.61 x 10(5) dyn/cm2. At a pressure of 35 cm H2O, the modulus reached a limiting value of approximately 6.0 x 10(6) dyn/cm2. In the physiological pressure range, the relative wall thickness (h/R0) of the canine thoracic duct was approximately 3.5%, which was much lower than that reported for canine arterial segments and similar in value to that of the canine jugular vein. In conclusion, the pressure-diameter curve of the canine thoracic duct was shown to resemble that of venous vessels. However, the circumferential elastic modulus of the thoracic duct wall was lower than the moduli of veins, proving that lymphatics are more compliant than veins. This suggests lymph flow in the thoracic duct may be better promoted by external compression of the lymphatic vessel.     

The early development of the lymphatic system in mouse embryos.

The early development of the lymphatic system was studied in embryos of an inbred strain of the laboratory mouse. During the first stage of its development the system is represented by a more or less regular series of small and blind-ending outgrowths of the major embryonic veins which develop in a cranio-caudalward direction from the jugular to the pelvic region. As a result of differences in growth rates of adjacent anatomical structures this series of early lymphatic primordia becomes subdivided into 4 singular primordia and 12 groups of primordia. After the constituents of each group of early primordia have fused, 16 isolated lymphatic plexuses (sacs) are formed of which 14 are in bilaterally symmetric and 2 are in a median line position: i.e. bilaterally: (1) the jugulo-axillary lymph sac situated lateral to the anterior cardinal vein and dorsal to the primitive ulnar vein and its major branch, the external mammary vein, (2) the paratracheal lymph plexus situated medial to the anterior cardinal vein, (3) the internal thoracic lymph plexus situated lateral to the thoracic part of the posterior cardinal vein, (4) the thoracic ducts situated medial to the thoracic part of the posterior cardinal vein, (5) the lumbar lymph plexus situated dorso-lateral to the abdominal part of the posterior cardinal vein, (6) the subcardinal lymph plexus and (7) the iliac lymph plexus situated ventro-lateral to the abdominal part of the posterior cardinal vein; and in the median line: (8) the subtracheal lymph plexus situated at the confluence of the pulmonary veins and (9) the mesenteric lymph plexus situated near the confluence of the splenic and the superior mesenteric veins. Except for some openings at the jugulo-subclavian confluence all connections with the veins disappear. From the primordia extensions grow out centrifugally. They invade the surrounding tissues and, in part, fuse with similar sprouts of adjacent primordia. In this way a continuous system of lymph truncs is formed that opens into the venous system at the jugulo-subclavian confluence.     

The regulation of water-salt exchange in a disorder of the integrity of the lymph circulation system]

The mechanisms regulating the water-salt metabolism have been investigated in the experiment on dogs with a disturbance of the lymph flow system. The function of a regulator of the water-salt metabolism is found to be peculiar to the lymphatic system which is effected by means of the humoral properties of the lymph and discreteness of its static pressure in the thoracic lymphatic duct. The central lymph exerts a stabilizing effect on both the osmo- and volumoregulatory functions of the kidneys, cardio- and hemodynamics. The state of acute lymphohypertension in the system of the thoracic lymphatic duct activates the mechanisms of the water-salt metabolism aimed at decreasing the volume of the extracellular fluid.     

Anatomy and topography of external iliac lymph nodes in adults]

The investigation of the external iliac lymph nodes has been performed in 152 preparations of corpses of mature persons of both sex, who died from causes not connected with any disease of the lymphatic system, lower extremities and pelvic organs. The external iliac lymph nodes and their afferent and efferent lymphatic vessels have been revealed by means of interstitial injection of the lower extremities and pelvic organs, as well as by means of direct injection of Gerota mass into the lymphatic vessels. Form, amount, dimensions and topography of common iliac lymph nodes have been studied. Lymphatic vessels, running from certain parts and organs of the body to various subgroups of the external iliac lymph nodes have been described, as well as efferent lymph vessels of these nodes. The external iliac lymph nodes are constant formations; the largest of them--lymph nodes of the lacuna--are nodes of the I step for the lower extremity lymph vessels. In 54% of cases in persons of both sex positive (right-sided) asymmetry has been revealed. Total amount of the iliac lymph nodes prevails in men, while their size is greater in women. The size of these nodes in persons of both sex is greater to the left than to the right. There are connections (in 3% of cases) between the external iliac lymph nodes and aortal and lumbar nodes of the opposite side.     

Anatomy and topography of the common iliac lymph nodes in human beings in the 1st period of maturity

The investigation of common iliac lymph nodes has been performed in 20 corpses of the first mature age of both sex (5 male and 5 female corpses) of persons died from causes not connected with the lymphatic system diseases, the lower extremities and the pelvic organs. The common iliac lymph nodes with their afferent and efferent lymphatic vessels are revealed by means of interstitial injection into the lower extremities and the pelvic organs and with direct injection into the lymphatic vessels. The form, amount, size and topography of the common iliac lymphatic vessels have been studied. The lymphatic vessels, that go from certain body parts and organs to various subgroups of the common iliac lymph nodes, as well as the lymphatic vessels that connect the nodes both within the subgroup and also between the subgroups. The amount and size of the lymphatic nodes of the lateral subgroup predominate over the nodes of other subgroups of the common iliac lymph nodes; the amount of the common iliac lymph nodes predominates in men, and their size--in women. Amount of these nodes in the right and their size in the left predominate in both sex. Among the common iliac lymph nodes there are no teniform nodes, and efferent lymphatic vessels of the lateral and medial subgroup of the common iliac lymph nodes in 15% of cases run towards the lumbar nodes in the opposite side.     

The interrelations of the lymphatic capillaries with the nerve structures in the wall of the small intestine]

The character of interrelations of nervous structures and the lymphatic capillary walls has been studied in cats. Under the light microscope twisted nervous fiber terminals of the intestinal neuron dendrites have been revealed around the lymphatic capillaries. Electron microscopical investigation has not revealed any specialized contacts of the nervous terminals and the lymphatic capillary walls. The receptors and terminals of axons do not situate nearer than 10 nm from the latter. According to the structure of synaptic vesicles among the axonal terminals next to the lymphatic capillary walls cholinergic, adrenergic and purinergic ones are described. The influence of the nervous system to the function of the small intestine lymphatic capillaries is mediated via the precapillary space. The neuromediators from the axonal terminals get into it owing to absence of neurolemmocytic membranes around them.