Microscopic analysis of lymphatic vessels in primary lymphedematous skin

X. Wu; R. Li; N. Liu

doi:10.1055/s-0037-1621796

Phlebologie, Table of Contents

Phlebologie 2012; 41(01): 13-17
DOI: 10.1055/s-0037-1621796

Originalarbeit

Schattauer GmbH

Microscopic analysis of lymphatic vessels in primary lymphedematous skin

Mikroskopische Analyse von Lymphgefäßen in primär lymphödematöser Haut

X. Wu

¹Lymphology Center of Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

,

R. Li

²Department of Osthopaedcs, the Second Hospital of Fuzhou, Fujian 35000, China

,

N. Liu

¹Lymphology Center of Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

› Author Affiliations

Abstract

Zusammenfassung

Hintergrund: Obwohl das Lymphsystem der Haut bei den primären Lymphödemen einbezo-gen ist, werden die Morphologie und die An-ordnung der Lymphgefäße in der betroffenen Hautregion der unteren Extremität bei dieser Krankheit wenig beschrieben und verstanden. Unser Ziel war es, die strukturellen und räumlichen Eigenschaften der Lymphgefäße in der be-troffenen Hautregion der unteren Extremität bei Patienten mit primären Lymphödemen zu charakterisieren und ihre Rolle bei dieser Krankheit herauszuarbeiten.

Methoden: Es wurden Hautbiopsien der unteren Extremität von 14 Patienten mit primärem Lymphödem sowie von 10 altersmäßig ent-sprechenden Kontrollen entnommen und immunhistochemisch sowie mikroskopischeuntersucht unter Verwendung von podoplanin-Antikörpern (einem lymphatischen Marker). Die Lymphgefäße jedes Abschnittes wur-den gezählt und der innere luminale Durchmesser bestimmt.

Ergebnisse: Die Gesamtdichte und der innere luminale Durchmesser der Lymphgefäße in der betroffenen Haut der untereren Extremität der Patienten mit primärem Lymph-ödem waren verglichen mit Kontrollen größer (p=0,004 bzw. p=0,014 ). Im oberen Bereich der Lederhaut bis 300 μm war die Dichte der Lymphgefäße der Lymphödem-Patienten niedriger im Vergleich zu den Kontrollen (p=0,00). Demgegenüber war die Dichte der Lymphgefäße in der tiefen Lederhaut (>300 μm) bei primärem Lymphödem höher als bei den Kontrollen (p=0,00).

Zusammenfassung: Die betroffene Haut der unteren Extremität der Primärlymphödem-Pa-tienten wird gekennzeichnet durch die Hyper-plasie und Dilatation von Lymphvasculaturen hauptsächlich in der tiefen Lederhaut, was auf eine pathogene Rolle bei der Entstehung und der klinischen Manifestation der Krankheit hindeuten könnte.

Summary

Background: Although skin lymphatic system is implicated in primary lymphedema, the morphology and distribution of lymphatic vessels in the affected skin of the lower extremity of this disease are less described and understood. Our aim was to characterize the structural and distributional features of lymphatic vessels in the affected skin of the lower extremity of primary lymphedema patients and pinpoint their role in this disease.

Methods: Skin biopsies of lower limb of 14 patients with primary lymphedema and 10 age-matched controls were performed for immunohistochemistry microscopic studies using podoplanin (a lymphatic marker) antibodies. All lymphatic vessels present in each section were counted and inner luminal diameter was measured by software.

Results: The total density and inner luminal diameter of lymphatic vessels in the affected skin of the lower extremity of primary lymphedema patients were greater compared with controls (p=0.004, p=0.014, respectively). However, in the superficial 300 μm band of dermis, the density of lymphatic vessels in primary lymphedema was lower with respect to controls (p=0.00). In contrast, in deep dermis (>300 μm), the density of lymphatic vessels in primary lymphedema was significantly higher compared with controls (p=0.00).

Conclusion: The affected skin of the lower extremity of primary lymphedema patients is characterized by hyperplasia and dilation of lymphatic vasculature mainly located in deep dermis, which might have a pathogenic role in the evolution and in the clinical manifestations of the disease.

Schlüsselwörter

mikroskopisch - lymphatische Gefäße - primäres - Lymphödem

Keywords

Microscopic - Lymphatic vessels - Primary lymphedema

Full Text

References

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