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 lymphatic vessels and regional lymph nodes of the rectum in newborn infants and children to 3 years of age

In 30 corpses of newborns and children up to 3 years of age, by means of the intratissue and direct injection of the modified Gerota's mass, certain increase in number and size of the superficial inguinal lymph vessels belonging to the superior-medial group, as well as the pararectal and superior rectal lymph nodes has been noted. The diameter of both afferent and efferent lymphatic vessels in the nodes mentioned in children of 1-3 years of age is greater than in the newborns. The number of the afferent vessels running towards these nodes in most cases, regardless the age, prevail over the efferent ones, and the diameter of the latter is greater than in the afferent vessels. The pararectal lymph nodes in 80% of cases are the nodes of the first step for the lymph flowing from the rectum, in 15% - the nodes of the first and second steps, simultaneously, and in 5% - of the third and fourth steps. The superior pararectal lymph nodes in 80% of cases are the nodes of the third and fourth steps, and in 20% of cases - those of the first and second steps for the lymph flowing from the rectum.     

Anatomical variants of the lymphatic vessels connecting the inguinal lymph nodes]

The study of anatomical variants of lymphatic vessels connecting inguinal lymph nodes was carried out on 56 corpses of adult persons of both sex whose deaths were not connected with lesions in the lymphatic system of the pelvis and lower extremities. The inguinal lymph nodes and their afferent and efferent lymphatic vessels were detected by the method of intradermal injection and by the method of direct injection into the lymphatic vessels. It was stated that groups of the inguinal lymph nodes, as well as the nodes in every group determined, can serve as nodes of different stages for afferent lymphatic vessels running from different parts of the body and organs.     

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.     

Individual and sex variation in the inguinal lymph nodes in man]

Under investigation were the lymph nodes on the anterior surface of the femur in the area of the femural triangle in 96 preparations of lower extremities of corpses of people of either sex in the age from 31 to 82 years. The Gerota's mass was injected into the skin of feet, external genitalia and the skin of the lower part of the anterior wall of the abdomen. It was established that the total amount of the inguinal lymph nodes in men was greater than in women, the size of the superficial nodes in women was greater than of those in men, while the size of profound lymph nodes in men was greater than in women. The amount of the inguinal lymph nodes was proportional to the Skerly's index and the dimensions were inversely proportional to their amount. The amount of inguinal lymph nodes in persons of either sex of a dolichomorphic type of figure was greater than in persons of a brachymorphic type. The dimensions of the nodes in persons of brachymorphic type of figure were predominant.     

Individual and sexual characteristics of the common iliac lymph nodes in elderly persons

The common iliac lymph nodes (CILN) have been investigated on 24 preparations from corpses of elderly persons (5 male and 7 female corpses), died from the causes not connected with the lymphatic system diseases, lower extremities and pelvic organs. The CILN with their afferent and deferent lymphatic vessels are revealed by means of interstitial injection into the lower extremities and pelvic organs, as well as by means of direct injection into lymphatic vessels. The form, amount, size and topography of CILN are studied. Lymphatic vessels, running from certain parts of the body and organs to various subgroups of CILN are described, as well as lymphatic vessels, connecting the nodes both within each subgroup and between the subgroups. There is a tendency in prevalence of amount and size of the lateral subgroup of the lymph nodes over the nodes of other subgroups of CILN; tendency in prevalence of amount of the lymph nodes in men, and their size--in women; prevalence of amount of right CILN and their size in the left--in persons of both sex; in 70% of the cases the amount of afferent lymphatic vessels to CILN prevails over that of the deferent lymph nodes.     

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)     

Anatomy of the lymph vessels and nodes of the head and neck in green marmosets]

In 50 mature green monkeys, the lymphatic system of the skin on the hairy part of the skull (occipital, parietal, frontal) and on the face was studied. The lymphatic vessels of cranial and cervical organs flow into submental, submandibular (anterior, medial, posterior) lymph nodes and into profound cervical (cranial, medial, caudal) lymph nodes. Lymph nodes together with efferent lymphatic vessels form lymph collectors of the neck which follow the blood vessels branching: superficial jugular, profound jugular and paratracheal network.     

Isolation and purification of afferent lymph dendritic cells that drain the skin of cattle

Dendritic cells (DCs) are central to the induction of immune responses and are a pivotal control point that determines the outcome of infectious challenge. Cannulation of afferent lymphatic vessels allows the isolation of large numbers of lymph DCs. First, lymph nodes that are draining the skin are surgically removed (takes approximately 1 h). Over a period of 6-8 weeks, afferent lymphatic vessels re-anastomose with the efferent duct, forming larger 'pseudoafferent' lymphatic vessels that can be surgically cannulated. Surgical cannulation takes 2 h to perform; daily maintenance of the catheter requires 30 min. Isolation of lymph cells requires 1 h and an additional 60-180 min to enrich or purify the DCs. The lymph can be harvested for up to 1 month, with relatively constant cell numbers and subset distribution throughout this period. This technique, although technically demanding, facilitates studies of DCs and other cells that traffic in the lymph in both the steady state and following antigenic exposure.     

Brugia pahangi: susceptibility and macroscopic pathology of golden hamster.

Twenty male hamsters were inoculated with 95 to 150 infective larvae of B. pahangi via the subcutaneous route. Worms recovered from 19 hamsters averaged 14% (0–32) from 11 hamsters killed at 105–195 days after infection and 16% (5–19) from 8 hamsters examined at 23–45 days after infection. Approximately one-half of the worms recovered were from the lymphatic vessels of the testes, epididymis, and spermatic cord. A few were found in afferent or efferent vessels of regional lymph nodes. The remaining worms were from the heart and lungs. Low-level microfilaremias were observed in 10 of 12 hamsters held for over 100 days. The average prepatent period was 89 days (65–128). Worms were recovered for up to 3 weeks following inoculation of nine hamsters via the intraperitoneal route with 100–400 infective larvae of B. pahangi.Gross lymphatic pathologic lesions consisted of moderate to marked dilation of lymphatic vessels, enlargement of regional lymph nodes, and numerous lymphthrombi and emboli. Macroscopic changes were most consistent and severe in the lymphatic vessels of the testes, epididymis, and spermatic cord and were noted less frequently in the afferent or efferent vessels of various regional lymph nodes. Areas of reddish discoloration were observed frequently on the serosal surface of the lung in infected hamsters.     

Regeneration of autotransplanted lymph node fragments

Summary In normal young minipigs thin slices of autologous mesenteric or superficial inguinal lymph nodes were implanted either in the greater omentum or subcutaneously in the groin region. The regeneration was studied histologically and connections between the afferent lymphatics and the regenerated tissue were checked. In the greater omentum, no regenerated lymph node tissue was found. In the inguinal region, lymphoid tissue with all the typical lymph node compartments was identified following antigenic stimulation in the draining area. Sinuses, germinal centres with a lymphatic corona, and a paracortex with typical high endothelial venules were seen. There was evidence of afferent lymphatics, e.g., macroscopically visible lymphatics, the occurrence of a subcutaneously injected dye, the effect of antigenic stimulation and a normal lymph node structure. Avascular transplants of autologous lymph node fragments regenerate subcutaneously, possibly providing a future technique for treating lymphoedema after radical excision or irradiation of lymph nodes.     

The lymphatic system in body homeostasis: physiological conditions

The lymphatic system is an organized network composed of functionally interrelated lymphoid tissue, and transportation pathways of tissue fluid/lymph and lymphoid cells. Its main components are 1. migrating dendritic cells, macrophages and lymphocytes, organized lymphoid tissue such as lymph nodes, thymus, spleen, bone marrow, and lymphoid tissue in gut and lungs, liver lymphoid cells, and the dendritic cell network of nonlymphoid organs; 2. vessels (intercellular space, lymphatics, and perivascular spaces); 3. fluids (tissue fluid and lymph). The lymphatic system can be divided into the following compartments: peripheral (from the interstitial space to and within the nearest lymph node), and central (efferent lymphatics, cysterna chyli, and thoracic duct, all lymphoid organs). Organs and tissues with the most active afferent arm of the lymphatic system are skin, gut, and lungs. These are the body structures exposed to the external environment. All other nonlymphoid bodily tissues are also percolated by tissue fluid/lymph, and contain a network of dendritic cells and macrophages. Data obtained from normal human subjects on lymph composition and flow are presented. Future trends in lymphatic research are outlined.     

Lymphatic bed of layers of the abdominal wall in the human inguinal area]

Lymphatic bed in the layers of the inguinal area was studied in connection with age in 70 human corpses. Polychromic injection of arteries, veins and lymphatic bed, staining of preparations after van Gieson, Weigert, with hematoxylin-eosin and morphometry were the methods applied. It was stated that lymphatic capillaries penetrate through all the layers forming the abdominal wall of the human inguinal area; they arrange interconnected networks in dermis, in external and internal oblique and transversal muscles and in their aponeuroses, as well as in fasciae and in the peritoneum. The lymphatic bed in question changes during ontogenesis. Age transformations of the lymphatic capillaries are in connection with functional loading on the anterior abdominal wall. Intraorganic connections existing between the lymphatic vessels of the anterior abdominal wall and the organs of the small pelvis (urinary bladder, uterus, rectum, etc.) are revealed, they are of a rather great interest for physicians.     

Lymphatic vessels in the capsule of the lymph node

By means of the injection method the lymphatic vessels, running to the lymph nodes of various localization, have been studied. Their architectonics in the lymph node capsule is revealed. In the capsule the afferent vessels make peculiar broom-like formations. They are named terminal arborizations of afferent lymphatic vessels (TAALV). Two types of such arborizations are described: palm-like, peculiar for the somatic type of the lymph nodes, and tree-like, specific for visceral nodes. The TAALV diameter is 15-20 mcm. They come across the nodal capsule, penetrating it obliquely with numerous holes. In the TAALV wall myocytes are revealed. Together with the capsule muscular elements they might play a role of the most important factors in the mechanism of lymph circulation.     

Lymphatic vessels of the upper extremity and their relation to nodes in the axillary area in healthy subjects and lymph flow blockade

Large and small lymphatic vessels have been studied roentgenologically on the medial, lateral, posterior and anterior surfaces of the upper extremity in 113 patients at the age of 19-63 years at blockade of the lymphatic stream. On the medial and lateral surfaces the lymphatic vessels are filled with the contrast substance via anatomical approaches from the palmar and dorsal sides of the forearm. With isolated contrasting of various large lymphatic vessels, zones in the skin and in the subcutaneous fatty layers drained by them are revealed, as well as distribution of small vessels in the forearm and shoulder in each region. Variants of large lymphatic vessels and their tributaries are defined; an essential variability of their inflow into the axillary lymph nodes from various anatomical areas of the upper extremity is found. Into every 1-4 groups of the lymph nodes of the axillary area, 1-3 large vessels inflow, through them the contrast substance switches from the same anatomical zone repeatedly.     

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.     

Individual and age-related differences in the anatomy of the main deferent lymphatic vessels of the human heart and their applied significance

One hundred human hearts of various age have been investigated. Structure, size of their main deferent lymphatic vessels are defined by the organ's form, sex and age of the persons. According to the position signs, extreme forms of their topography have been revealed. In the left--the course in the adventitia of the anterior wall of the pulmonary trunk and of the ascending aorta. In the left--the course in the adventitia of the right lateral wall of the ascending aorta and of the pulmonary trunk. The number of the extraorganic vessels, that bring lymph out of the heart, is from 1 up to 3. The anastomoses made between certain parts of the lymph nodes and the extraorganic lymphatic vessels in the transplanted and removed hearts are more economic.     

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.     

Afferent and efferent interfaces of lymph nodes are distinguished by expression of lymphatic endothelial markers and chemokines

BACKGROUND: Lymph nodes (LNs) are important sites of connection between the sampled peripheral tissues, the many cells of the immune system, and the blood. The organization of the interface between the afferent and efferent lymphatic vasculature and LN parenchyma is incompletely understood, and obtaining a better understanding of these tissue microenvironments will contribute to an improved understanding of overall lymphatic function. METHODS AND RESULTS: We used histologic approaches to define the distributions of cells expressing lymphatic endothelial cell (LEC) markers in LNs from healthy, simian immunodeficiency virus (SIV) infected, or Mycobacterium tuberculosis infected cynomolgus macaques. Cells at the afferent and efferent interfaces of LNs from all animals showed differential expression of LEC markers, with podoplanin, Prox-1, and VEGFR3 expressed in both microenvironments, but with LYVE-1 expressed only at the efferent interface. The chemokine CCL20 was uniquely expressed at the afferent interface by cells co-expressing podoplanin, and this expression was increased during SIV or M. tuberculosis infection. In contrast, only a small proportion of cells expressing the CCR7 ligand CCL21 co-expressed podoplanin. Treatment of model LECs with the TLR3 ligand poly(I:C) or gamma-irradiated M. tuberculosis increased production of CCL20 without altering CCL21 or LEC marker expression. CONCLUSIONS: This study provides a comprehensive mapping of the organization of the lymphatic endothelial network entering and exiting LNs in health and in chronic infectious diseases in a nonhuman primate model. The differences we have defined between the afferent and efferent interfaces of LNs could inform the future design of vaccines and immunotherapies.     

Structure of the inguinal lymph nodes after extirpation of the pancreas

Swiching off the external and internal secretion of the pancreas by means of extirpation of the organ demonstrates a progressive hypoplasia of the immunocompetent tissue in the inguinal lymphatic nodes. The involution is determined by decreasing number of small, middle and large lymphocytes in the cortical part of the node. Together with the decreasing number of the lymphatic nodules, by the 20th-60th days after the operation the germinative centers become poor in middle, large lymphocytes and in lymphoblasts. Among the cells mentioned, mitotic activity is decreased. Hence, thymus-dependent, but to a greater extent, thymus--independent zones of the lymphatic nodes are subjected to involution.