Pathological Steps of Cancer-Related Lymphedema: Histological Changes in the Collecting Lymphatic Vessels after Lymphadenectomy
Identifieur interne : 004045 ( Main/Exploration ); précédent : 004044; suivant : 004046Pathological Steps of Cancer-Related Lymphedema: Histological Changes in the Collecting Lymphatic Vessels after Lymphadenectomy
Auteurs : Makoto Mihara [Japon] ; Hisako Hara [Japon] ; Yohei Hayashi [Japon] ; Mitsunaga Narushima [Japon] ; Takumi Yamamoto (chirurgien) [Japon] ; Takeshi Todokoro [Japon] ; Takuya Iida [Japon] ; Naoya Sawamoto [Japon] ; Jun Araki [Japon] ; Kazuki Kikuchi [Japon] ; Noriyuki Murai [Japon] ; Taro Okitsu [Japon] ; Iori Kisu [Japon] ; Isao Koshima [Japon]Source :
- PLoS ONE [ 1932-6203 ] ; 2012.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Cellules endothéliales (anatomopathologie), Cellules endothéliales (ultrastructure), Collagènes fibrillaires (ultrastructure), Desmosomes (anatomopathologie), Desmosomes (ultrastructure), Femelle, Humains, Lymphadénectomie, Lymphoedème (anatomopathologie), Lymphoedème (étiologie), Myocytes du muscle lisse (anatomopathologie), Myocytes du muscle lisse (ultrastructure), Sujet âgé, Tumeurs (), Vaisseaux lymphatiques (anatomopathologie).
- MESH :
- anatomopathologie : Cellules endothéliales, Desmosomes, Lymphoedème, Myocytes du muscle lisse, Vaisseaux lymphatiques.
- étiologie : Cellules endothéliales, Desmosomes, Lymphoedème, Myocytes du muscle lisse.
- ultrastructure : Adulte, Adulte d'âge moyen, Collagènes fibrillaires, Femelle, Humains, Lymphadénectomie, Sujet âgé, Tumeurs.
English descriptors
- KwdEn :
- Adult, Aged, Desmosomes (pathology), Desmosomes (ultrastructure), Endothelial Cells (pathology), Endothelial Cells (ultrastructure), Female, Fibrillar Collagens (ultrastructure), Humans, Lymph Node Excision, Lymphatic Vessels (pathology), Lymphedema (etiology), Lymphedema (pathology), Middle Aged, Myocytes, Smooth Muscle (pathology), Myocytes, Smooth Muscle (ultrastructure), Neoplasms (complications), Neoplasms (surgery).
- MESH :
- chemical , ultrastructure : Fibrillar Collagens.
- complications : Neoplasms.
- etiology : Lymphedema.
- pathology : Desmosomes, Endothelial Cells, Lymphatic Vessels, Lymphedema, Myocytes, Smooth Muscle.
- surgery : Neoplasms.
- ultrastructure : Desmosomes, Endothelial Cells, Myocytes, Smooth Muscle.
- Adult, Aged, Female, Humans, Lymph Node Excision, Middle Aged.
Abstract
To date, an electron microscopy study of the collecting lymphatic vessels has not been conducted to examine the early stages of lymphedema. However, such histological studies could be useful for elucidating the mechanism of lymphedema onset. The aim of this study was to clarify the changes occurring in collecting lymphatic vessels after lymphadenectomy.
The study was conducted on 114 specimens from 37 patients who developed lymphedema of the lower limbs after receiving surgical treatment for gynecologic cancers and who consulted the University of Tokyo Hospital and affiliated hospitals from April 2009 to March 2011. Lymphatic vessels that were not needed for lymphatico venous anastomosis surgery were trimmed and subsequently examined using electron microscopy and light microscopy.
Based on macroscopic findings, the histochemical changes in the collecting lymphatic vessels were defined as follows: normal, ectasis, contraction, and sclerosis type (NECST). In the ectasis type, an increase in endolymphatic pressure was accompanied by a flattening of the lymphatic vessel endothelial cells. In the contraction type, smooth muscle cells were transformed into synthetic cells and promoted the growth of collagen fibers. In the sclerosis type, fibrous elements accounted for the majority of the components, the lymphatic vessels lost their transport and concentrating abilities, and the lumen was either narrowed or completely obstructed.
The increase in pressure inside the collecting lymphatic vessels after lymphadenectomy was accompanied by histological changes that began before the onset of lymphedema.
Url:
DOI: 10.1371/journal.pone.0041126
PubMed: 22911751
PubMed Central: 3404077
Affiliations:
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type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Hara, Hisako" sort="Hara, Hisako" uniqKey="Hara H" first="Hisako" last="Hara">Hisako Hara</name><affiliation wicri:level="4"><nlm:aff id="aff1"><addr-line>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan</addr-line></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Hayashi, Yohei" sort="Hayashi, Yohei" uniqKey="Hayashi Y" first="Yohei" last="Hayashi">Yohei Hayashi</name><affiliation wicri:level="4"><nlm:aff id="aff1"><addr-line>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan</addr-line></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Narushima, Mitsunaga" sort="Narushima, Mitsunaga" uniqKey="Narushima M" first="Mitsunaga" last="Narushima">Mitsunaga Narushima</name><affiliation wicri:level="4"><nlm:aff id="aff1"><addr-line>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan</addr-line></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Yamamoto, Takumi" sort="Yamamoto, Takumi" uniqKey="Yamamoto T" first="Takumi" last="Yamamoto">Takumi Yamamoto (chirurgien)</name><affiliation wicri:level="4"><nlm:aff id="aff1"><addr-line>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan</addr-line></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName><placeName><settlement type="city">Tokyo</settlement><region type="province">Région de Kantō</region></placeName><orgName type="university" n="3">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Todokoro, Takeshi" sort="Todokoro, Takeshi" uniqKey="Todokoro T" first="Takeshi" last="Todokoro">Takeshi Todokoro</name><affiliation wicri:level="4"><nlm:aff id="aff1"><addr-line>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan</addr-line></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Iida, Takuya" sort="Iida, Takuya" uniqKey="Iida T" first="Takuya" last="Iida">Takuya Iida</name><affiliation wicri:level="4"><nlm:aff id="aff1"><addr-line>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan</addr-line></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Sawamoto, Naoya" sort="Sawamoto, Naoya" uniqKey="Sawamoto N" first="Naoya" last="Sawamoto">Naoya Sawamoto</name><affiliation wicri:level="4"><nlm:aff id="aff1"><addr-line>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan</addr-line></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Araki, Jun" sort="Araki, Jun" uniqKey="Araki J" first="Jun" last="Araki">Jun Araki</name><affiliation wicri:level="4"><nlm:aff id="aff1"><addr-line>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan</addr-line></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Kikuchi, Kazuki" sort="Kikuchi, Kazuki" uniqKey="Kikuchi K" first="Kazuki" last="Kikuchi">Kazuki Kikuchi</name><affiliation wicri:level="4"><nlm:aff id="aff1"><addr-line>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan</addr-line></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author><author><name sortKey="Murai, Noriyuki" sort="Murai, Noriyuki" uniqKey="Murai N" first="Noriyuki" last="Murai">Noriyuki Murai</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Department of Vascular Surgery, Saiseikai Kawaguchi General Hospital, Saitama, Japan</addr-line></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Vascular Surgery, Saiseikai Kawaguchi General Hospital, Saitama</wicri:regionArea><wicri:noRegion>Saitama</wicri:noRegion></affiliation></author><author><name sortKey="Okitsu, Taro" sort="Okitsu, Taro" uniqKey="Okitsu T" first="Taro" last="Okitsu">Taro Okitsu</name><affiliation wicri:level="3"><nlm:aff id="aff3"><addr-line>Department of Rehabilitation Medicine, Keio University, Tokyo, Japan</addr-line></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Rehabilitation Medicine, Keio University, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Kisu, Iori" sort="Kisu, Iori" uniqKey="Kisu I" first="Iori" last="Kisu">Iori Kisu</name><affiliation wicri:level="3"><nlm:aff id="aff4"><addr-line>Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan</addr-line></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region></placeName></affiliation></author><author><name sortKey="Koshima, Isao" sort="Koshima, Isao" uniqKey="Koshima I" first="Isao" last="Koshima">Isao Koshima</name><affiliation wicri:level="4"><nlm:aff id="aff1"><addr-line>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo, Japan</addr-line></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, The University of Tokyo, Tokyo</wicri:regionArea><placeName><settlement type="city">Tokyo</settlement><region type="région">Région de Kantō</region><settlement type="city">Tokyo</settlement></placeName><orgName type="university">Université de Tokyo</orgName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Desmosomes (pathology)</term><term>Desmosomes (ultrastructure)</term><term>Endothelial Cells (pathology)</term><term>Endothelial Cells (ultrastructure)</term><term>Female</term><term>Fibrillar Collagens (ultrastructure)</term><term>Humans</term><term>Lymph Node Excision</term><term>Lymphatic Vessels (pathology)</term><term>Lymphedema (etiology)</term><term>Lymphedema (pathology)</term><term>Middle Aged</term><term>Myocytes, Smooth Muscle (pathology)</term><term>Myocytes, Smooth Muscle (ultrastructure)</term><term>Neoplasms (complications)</term><term>Neoplasms (surgery)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Cellules endothéliales (anatomopathologie)</term><term>Cellules endothéliales (ultrastructure)</term><term>Collagènes fibrillaires (ultrastructure)</term><term>Desmosomes (anatomopathologie)</term><term>Desmosomes (ultrastructure)</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie</term><term>Lymphoedème (anatomopathologie)</term><term>Lymphoedème (étiologie)</term><term>Myocytes du muscle lisse (anatomopathologie)</term><term>Myocytes du muscle lisse (ultrastructure)</term><term>Sujet âgé</term><term>Tumeurs ()</term><term>Vaisseaux lymphatiques (anatomopathologie)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="ultrastructure" xml:lang="en"><term>Fibrillar Collagens</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Cellules endothéliales</term><term>Desmosomes</term><term>Lymphoedème</term><term>Myocytes du muscle lisse</term><term>Vaisseaux lymphatiques</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Neoplasms</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Desmosomes</term><term>Endothelial Cells</term><term>Lymphatic Vessels</term><term>Lymphedema</term><term>Myocytes, Smooth Muscle</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Neoplasms</term></keywords><keywords scheme="MESH" qualifier="ultrastructure" xml:lang="en"><term>Desmosomes</term><term>Endothelial Cells</term><term>Myocytes, Smooth Muscle</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Cellules endothéliales</term><term>Desmosomes</term><term>Lymphoedème</term><term>Myocytes du muscle lisse</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Female</term><term>Humans</term><term>Lymph Node Excision</term><term>Middle Aged</term></keywords><keywords scheme="MESH" qualifier="ultrastructure" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Collagènes fibrillaires</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie</term><term>Sujet âgé</term><term>Tumeurs</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>To date, an electron microscopy study of the collecting lymphatic vessels has not been conducted to examine the early stages of lymphedema. However, such histological studies could be useful for elucidating the mechanism of lymphedema onset. The aim of this study was to clarify the changes occurring in collecting lymphatic vessels after lymphadenectomy.</p></sec><sec><title>Methods</title><p>The study was conducted on 114 specimens from 37 patients who developed lymphedema of the lower limbs after receiving surgical treatment for gynecologic cancers and who consulted the University of Tokyo Hospital and affiliated hospitals from April 2009 to March 2011. Lymphatic vessels that were not needed for lymphatico venous anastomosis surgery were trimmed and subsequently examined using electron microscopy and light microscopy.</p></sec><sec><title>Results</title><p>Based on macroscopic findings, the histochemical changes in the collecting lymphatic vessels were defined as follows: normal, ectasis, contraction, and sclerosis type (NECST). In the ectasis type, an increase in endolymphatic pressure was accompanied by a flattening of the lymphatic vessel endothelial cells. In the contraction type, smooth muscle cells were transformed into synthetic cells and promoted the growth of collagen fibers. In the sclerosis type, fibrous elements accounted for the majority of the components, the lymphatic vessels lost their transport and concentrating abilities, and the lumen was either narrowed or completely obstructed.</p></sec><sec><title>Conclusions</title><p>The increase in pressure inside the collecting lymphatic vessels after lymphadenectomy was accompanied by histological changes that began before the onset of lymphedema.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Rockson, Sg" uniqKey="Rockson S">SG Rockson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jensen, Mr" uniqKey="Jensen M">MR Jensen</name></author><author><name sortKey="Simonsen, L" uniqKey="Simonsen L">L Simonsen</name></author><author><name sortKey="Karlsmark, T" uniqKey="Karlsmark T">T Karlsmark</name></author><author><name sortKey="Bulow, J" uniqKey="Bulow J">J 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uniqKey="Hayashi Y" first="Yohei" last="Hayashi">Yohei Hayashi</name><name sortKey="Iida, Takuya" sort="Iida, Takuya" uniqKey="Iida T" first="Takuya" last="Iida">Takuya Iida</name><name sortKey="Kikuchi, Kazuki" sort="Kikuchi, Kazuki" uniqKey="Kikuchi K" first="Kazuki" last="Kikuchi">Kazuki Kikuchi</name><name sortKey="Kisu, Iori" sort="Kisu, Iori" uniqKey="Kisu I" first="Iori" last="Kisu">Iori Kisu</name><name sortKey="Koshima, Isao" sort="Koshima, Isao" uniqKey="Koshima I" first="Isao" last="Koshima">Isao Koshima</name><name sortKey="Murai, Noriyuki" sort="Murai, Noriyuki" uniqKey="Murai N" first="Noriyuki" last="Murai">Noriyuki Murai</name><name sortKey="Narushima, Mitsunaga" sort="Narushima, Mitsunaga" uniqKey="Narushima M" first="Mitsunaga" last="Narushima">Mitsunaga Narushima</name><name sortKey="Okitsu, Taro" sort="Okitsu, Taro" uniqKey="Okitsu T" first="Taro" last="Okitsu">Taro Okitsu</name><name sortKey="Sawamoto, Naoya" sort="Sawamoto, Naoya" uniqKey="Sawamoto N" first="Naoya" last="Sawamoto">Naoya Sawamoto</name><name sortKey="Todokoro, Takeshi" sort="Todokoro, Takeshi" uniqKey="Todokoro T" first="Takeshi" last="Todokoro">Takeshi Todokoro</name><name sortKey="Yamamoto, Takumi" sort="Yamamoto, Takumi" uniqKey="Yamamoto T" first="Takumi" last="Yamamoto">Takumi Yamamoto (chirurgien)</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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