The angiogenic theory to the development of human lymphatics is not clear. The objective of this study was to investigate the development of human lymphatics. Semi-thin and thin paraffin sections from human mature cystic ovarian teratoma tissues were studied using light and electron microscopy. Lymphatics were formed by the differentiation of mesenchymal cells that gradually acquired morphological features of endothelial cells. It is suggested that in human mature cystic ovarian teratoma the lymphatic endothelium develops from mesenchymal cells, and not from cells derived from mature endothelium of a preexisting vein or lymphatic.
Endothelial Cells ; Endothelium ; Endothelium, Lymphatic ; Humans* ; Mesoderm ; Microscopy, Electron ; Paraffin ; Teratoma* ; Veins

We present a case of a 13-year-old boy with Gorham's disease involving the thoracic and lumbar spine, femur, and gastrointestinal (GI) tract, which was complicated by recurrent chylothorax and GI bleeding. The presenting symptoms were intermittent abdominal pain, back pain, and melena. Esophagogastroduodenoscopy and colonoscopy showed no abnormal lesions, but duodenal biopsy showed marked dilation of the lymphatics in the mucosa and submucosa, which revealed positive staining with a D2-40 immunohistochemical marker. In cases of GI bleeding with osteolysis, the expression of a D2-40 marker in the lymphatic endothelium of the GI tract may help to diagnose GI involvement in Gorham's disease. To the best of our knowledge, this is the first case report to pathologically demonstrate intestinal lymphatic malformation as a cause of GI bleeding in Gorham's disease.
Abdominal Pain ; Adolescent ; Back Pain ; Biopsy ; Child ; Chylothorax ; Colonoscopy ; Duodenum* ; Endoscopy, Digestive System ; Endothelium, Lymphatic ; Femur ; Gastrointestinal Tract* ; Hemorrhage ; Humans ; Male ; Melena ; Mucous Membrane ; Occult Blood ; Osteolysis ; Osteolysis, Essential ; Spine

Lymphatic metastasis is a continuous and complicated process. The detailed mechanisms of lymphatic metastasis are still not very clear, despite considerable research efforts in recent years. Previously, it was commonly accepted that there were no lymphatic vessels in the primary tumor. However, recent studies have demonstrated that lymphatic vessels are detectable in certain types of cancer, and more and more evidence has shown that cancer cells invade into local lymph nodes mainly via peritumoral lymphatic vessels. Moreover, activated endothelial cells may also be important, having an influence on lymphatic metastasis of cancer cells. This article, based on recent research findings, provides an in-depth discussion of the relationship between lymphangiogenesis, tumor-derived lymphatic endothelial cells and lymphatic metastasis in head and neck cancer.
Carcinoma, Squamous Cell ; pathology ; secondary ; Endothelial Cells ; pathology ; physiology ; Endothelium, Lymphatic ; pathology ; physiopathology ; Head and Neck Neoplasms ; pathology ; Humans ; Lymphangiogenesis ; physiology ; Lymphatic Metastasis ; pathology ; Neoplasm Invasiveness

Based on the morphology and function of lymphatic vessel, and on the achievements of researches in the regulatory mechanism of lymphatic circulation, we fully considered the dynamic interaction of blood, interstitial fluid and lymph fluid; then we imitated and used Sungawa's method of analyzing the heart output, and finally set up a dynamic model for describing lymphatic circulation. Comparison of our calculating results with the data from Ikomi's experiment showed that they were identical, thus indicating that our model is of value in explaining the dynamic mechanism of lymphatic circulation. In this paper is especially calculated the relationship between lymph flow and massage frequency, which is useful for analyzing the effect of massage on the lymph flow rate with respect to this model.
Animals ; Computer Simulation ; Endothelium, Lymphatic ; cytology ; physiology ; Humans ; Lymph ; physiology ; Lymphatic Vessels ; physiology ; Models, Biological ; Nonlinear Dynamics ; Pressure ; Rabbits ; Rheology

PURPOSE: CD105 (endoglin) has been shown to be a more useful marker to identify the proliferating endothelium involved in tumor angiogenesis than are the panendothelial markers. The monoclonal antibody D2-40 is a specific lymphatic endothelial marker. METHODS: We investigated CD105, lymphatic vessel marker (D2-40), vascular endothelial growth factor (VEGD)-A and the VEGF-D expressions as possible prognostic markers in the endoscopic biopsy tissue of stomach cancer patients. The pre-operative endoscopic biopsies and surgical biopsies from 73 patients were immunostained for CD105, D2-40, VEGF-A and VEGF-D. Positively stained microvessels were counted in densely vascular foci (hot spots) at a x200 field in each specimen. RESULTS: The microvessel density (MVD) and lymphatic vessel density (LVD), according to the CD105 and D2-40 expressions of the endoscopic biopsies, showed a statistically significant correlation with the surgical biopsies. The MVD via CD105 a showed statistically significant correlation with the histologic differentiation, T-stage, nodal metastasis and stage in the endoscopic biopsies and surgical biopsies, respectively. The lympathic vessel density (LVD) via D2-40 showed a statistically significant correlation with T-stage, nodal metastasis and stage in the endoscopic biopsies. The expressions of VEGF-A and VEGF-D showed a statistically significant correlation with the MVD and LVD. CONCLUSION: The MVD, as determined by the CD105 expression and the LVD as determined by the D2-40 expression may be useful markers for predicting the invasiveness with using a pre-operative endoscopic biopsy of stomach cancer.
Biopsy* ; Endothelium ; Humans ; Lymphatic Vessels ; Microvessels ; Neoplasm Metastasis ; Stomach Neoplasms* ; Stomach* ; Vascular Endothelial Growth Factor A* ; Vascular Endothelial Growth Factor D ; Vascular Endothelial Growth Factors*

BACKGROUND: The anatomical relation between a malignant tumor and its vascular and lymphatic bed is an important influencing metastasis. Hox D3 is required for these expressions of integrin alpha v beta3 and urokinase plasminogen activator (uPA), which contribute to endothelial cell adhesion, invasion, and migration during angiogenesis. Recent studies in different tumor types have shown that vascular endothelial growth factor-C (VEGF-C), which displays a high specificity for lymphatic endothelium, is involved in tumor-induced lymphagiogenesis and lymphatic metastatic spread. OBJECTIVE: This study was designed to measure the expression of HOX D3 and VEGF-C in different skin cancers. METHODS: The expression of HOX D3 and VEGF-C was examined by immunohistochemical staining of 40 skin cancer tissue samples, including 8 keratoacanthomas, 8 extramammary paget's disease, 8 basal cell carcinomas, 8 squamous cell carcinomas and 8 malignant melanomas. RESULTS: Immunohistochemical analysis of 40 skin cancer tissue samples revealed a high expression of HOX D3 and VEGF-C in the more aggressive and invasive skin tumors, including squamous cell carcinomas and malignant melanomas. On the other hand, low expression was seen in the less-invasive skin tumors, including keratoacanthomas, extramammary paget's disease and basal cell carcinomas. Also the degree of expression of HOX D3 and VEGF-C showed a statistically-significant correlation with each skin tumor (p<0.05). CONCLUSION: These findings provide evidence that the upregulation of HOX D3 and VEGF-C might be involved in the promotion of angiogenesis and lymphagiogenesis in skin tumors and play an important role in metastasis.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Endothelial Cells ; Endothelium, Lymphatic ; Hand ; Integrin alphaV ; Keratoacanthoma ; Lymphangiogenesis ; Melanoma ; Neoplasm Metastasis ; Paget Disease, Extramammary ; Plasminogen Activators ; Sensitivity and Specificity ; Skin Neoplasms ; Skin* ; Up-Regulation ; Urokinase-Type Plasminogen Activator ; Vascular Endothelial Growth Factor C*

PURPOSE: Panendothelial markers such as factor VIII, CD34, CD31, CD105 (endoglin) and D2-40 are useful to identify proliferating endothelium that is related to tumor invasion. This study was designed to identify the correlation between the expressions of panendothelial and lymphatic vessel markers in preoperative biopsy specimens and the clinicopathologic factors. METHODS: Preoperative biopsy specimens from 72 patients were immunostained for CD105, CD34, CD31, Factor VIII and D2-40. The microvessel and lympathic vessel densities (MVD and LVD) were counted in dense vascular foci (hot spots) on a x200 field in each specimen. The correlation between these factors and the clinicopathologic parameters were analyzed. RESULTS: The MVD by CD105 showed statistically significant correlation with tumor emboli, the T-stage, nodal metastasis and the stage, and the MVD by CD34 had statistically significant correlation with tumor emboli, nodal metastasis and the stage. The lympathic vessel density (LVD) by D2-40 showed a statistically significant correlation with tumor emboli, the T-stage and nodal metastasis. CONCLUSION: The MVD by CD105 and the LVD by D2-40 in preoperative biopsy specimens of colorectal cancers may be useful markers for the prediction of invasiveness.
Biopsy* ; Colorectal Neoplasms* ; Endothelium ; Factor VIII ; Humans ; Lymphatic Vessels* ; Microvessels ; Neoplasm Metastasis

OBJECTIVETo investigate the distribution patterns and proliferative activity of lymphatic vessels in colorectal carcinomas (CRC) and their relationship with tumor metastasis and disease prognosis.

METHODSThe microlymphatic density (MLD) and microvascular density in tumoral and non-tumoral areas of 96 cases of CRC were evaluated by immunohistochemistry, using monoclonal antibodies for podoplanin and CD34 respectively. The Ki-67 expression of the lymphatic and blood vessels was detected by double-labeling immunohistochemistry. The relationship between MLD and clinicopathologic features and prognosis was analyzed.

RESULTSThe lymph vessels at central and superficia1 portions of CRC often had a reticular architecture with numerous tiny and ill-defined lumina, while those at the tumor borders had large and open lumina. The MLD at tumor borders (51.2 +/- 25.5) was significantly higher than that in normal colorectal mucosa (29.4 +/- 9.0) and other portions of CRC (P < 0.01). The Ki-67 labeling index of the lymphatic lining cells at tumor borders (0.23 +/- 0.17) was significantly higher than that in other portions of CRC (P < 0.05). The MLD significantly correlated with lymphatic involvement by tumor cells, regional lymph node metastasis and distant metastasis (P < 0.01). The 5-year survival rate was also significantly lower in patients with high MLD (P < 0.05).

CONCLUSIONSNeolymphatic vessels are commonly seen in CRC, especially at tumor borders. High MLD at tumor borders is associated with metastasis. The detection of MLD at tumor borders may thus be useful in predicting lymph node metastasis and prognosis in patients with CPC.

Adenocarcinoma ; immunology ; pathology ; physiopathology ; Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; immunology ; pathology ; physiopathology ; Endothelium, Vascular ; immunology ; Female ; Follow-Up Studies ; Humans ; Ki-67 Antigen ; metabolism ; Lymphangiogenesis ; Lymphatic Metastasis ; Lymphatic Vessels ; pathology ; Male ; Middle Aged ; Prognosis ; Survival Rate

Epithelioid hemangioendothelioma is a rare tumor of vascular endothelium that is considered to be of borderline malignancy. Typical sites of involvement include soft tissue and less frequently, liver and lung. A 45-year-old woman had found a nodule on left second finger. There were no specific personal or family history. Physical examination revealed a 0.7x0.7cm sized skin-colored hard nodule on the dorsum of the distal interphalangeal joint of left second finger. There were no lymphadenopathy, hepatosplenomegaly, or bone tenderness. The patient underwent an excision of the lesion. On microscopic examination, a moderately well-circumscribed nodule composed of sheets and cords of epithelioid cells, many of which possessed intracytoplasmic lumina, was noted in the dermis. Erythrocytes were seen within some of the lumina. On immunohistochemical staining, the cells showed positive staining for factor VIII-related antigen and smooth muscle actin, and negative staining for CD31, CD34 and S-100.
Actins ; Dermis ; Endothelium, Vascular ; Epithelioid Cells ; Erythrocytes ; Female ; Fingers ; Hemangioendothelioma, Epithelioid* ; Humans ; Joints ; Liver ; Lung ; Lymphatic Diseases ; Middle Aged ; Muscle, Smooth ; Negative Staining ; Physical Examination ; von Willebrand Factor

Cystic lymphangioma is an uncommon benign developmental tumor of the lymphatic system, seen rarely in adults. A 23-year-old man visited DKUDH complaining of the painless swelling in the right submandibular triangle area. It was reported that swelling had increased since 5 months ago. Clinically, fluctuant and mobile mass was palpated at the right submandibular area. CT scan showed a large, well-defined, homogenous low density mass, measuring 5.0X2.5X4.0 cm. T1W MRI scan demonstrated a large, multiseptated homogenous low signal mass with septum and rim enhancement. Proton-density and T2W MRI scan showed mass of high signal intensity. MRI scan was able to delineate better the enhanced multiseptation and extent of the lesion. Histopathologically, a lobulated cystic mass lined by a layer of flattened endothelium was observed.
Adult* ; Endothelium ; Humans ; Lymphangioma ; Lymphangioma, Cystic* ; Lymphatic System ; Magnetic Resonance Imaging ; Neck ; Tomography, X-Ray Computed ; Young Adult