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Thermography by Specialty
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Obstruction or destruction of the lymphatic channels may lead to the condition of lymphedema, an accumulation of normal, non-infected lymph fluid within the tissues distal to the lymph blockage creating a swollen limb. Surgical disruption of lymph vessels or removal of lymph nodes is the major cause of lymphedema in developed countries (Figure 11.44). Lymphedema can be classified as mild (10%–20%), moderate (20%–40%), or severe (>40%), referring to the percentage of increase in limb volume. In mild and moderate cases, the involved limb is diffusely warmer than contralateral by up to 2°C (3.6°F), though this increase may not be present in the case of decreased arterial inflow. Also, as lymphedema becomes severe, skin warming may not be present due to decreased muscular activity, soft tissue degeneration, skin fibrosis, and deposition of dysfunctional subdermal fat in the affected limb.198
Inflammatory, Hypersensitivity and Immune Lung Diseases, including Parasitic Diseases.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Filariasis - three forms are of medical importance - Loa-Loa, Wucheria bancrofti and Onchcercosis. Worms in this group produce microfilariae, which undergo maturation in an insect (often the mosquito, especially Culix fatigans) and are thence transferred to man. Loa-Loa worms are transferred by horse-flies and may produce small calcified nodules 'Calabar swellings' (named after a town in Nigeria). The filarial worms tend to lodge in regional lymph nodes and cause lymphatic obstruction by mechanical means when they are present in large numbers, and by inflammatory reaction when they die and disintegrate. The affected nodes enlarge and contain dilated sinusoids, the nodal obstruction causing dilatation of more peripheral lymph vessels and lymphoedema and 'elephantiasis'. A novel way of diagnosing the condition is to use scrotal ultrasound when dilated lymphatics (sometimes containing wriggling live worms) may be seen (Dreyer et al., 1994). Chylothoraces and thoracic duct obstruction are discussed on p. 14.10. Filariasis may also lead to endomyocardial fibrosis.
Facial anatomy
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
Although most of the fluid in blood is returned to the heart by blood vessels, a small portion remains as extracellular interstitial fluid. This fluid is high in white cells and drains into tiny, blind-ended, highly permeable lymph capillaries which collect fluid from surrounding tissues, carrying it into larger lymph vessels, which, in turn, drain into lymph nodes. Lymphatic vessels entering a lymph node are called afferent lymph vessels, and those leaving lymph nodes are called efferent lymph vessels. The lymphatic system has no central pump like the heart and instead relies on peristalsis of the lymph vessels themselves, as well as contraction of surrounding skeletal muscles. Anything which impairs lymphatic drainage, such as damage to lymph vessels or muscle paralysis, can cause an accumulation of tissue fluid, leading to lymphoedema and swelling. This can give a poor cosmetic result and may also leave patients at risk of infection.
The discovery of the lymphatic system in the 17th century. Part VII: the rise of vascular injection
Published in Acta Chirurgica Belgica, 2021
Raphael Suy, Sarah Thomis, Inge Fourneau
Nuck’s main work, titled Adenographia Curiosa, was published in 1691 [41]. In the dedication he compared himself with a merchant (Mercator) sailing unexplored rivers of bodily fluids in order to discover unknown lands and treasures. It appears from this book that he detected lymph vessels in nearly all organs and tissues, except in the brain in which, however, he suspected their presence. He was the first to describe lymph vessels in the tunics of pulmonary arteries, along the iliac arteries and aorta, in kidneys, and on the heart (Figure 6(a)). He stated that ‘along hidden pathways, unknown to the anatomist, lymph entered the nodes from where it flowed into larger lymph vessels and finally entered into the thoracic duct’. His most remarkable experiment was the injection of ‘his mercury’ via the nipple into avalvular lactiferous ducts, combined with a similar injection into an afferent intrathoracic lymph vessel, and of red-coloured wax in the corresponding internal mammary artery. In this way, he demonstrated that milk was neither lymph nor chyle, as commonly accepted in those days, but a specific liquid separated from arterial blood into the lactiferous ducts within the globules of the mammary glands, a phenomenon which, as he added, was strongly conditioned by the spirit (of the mother) [42,p.12–21]. To the question ‘Why is it that blood does not flow in the form of blood into lymph vessels?’ he answered: ‘all fluids originate from blood, but the smallest arteries admit only clear lymph’ [42,p.53–54].
Long-term outcome of lymph vessel transplantation after chronic lymphorrhea
Published in Case Reports in Plastic Surgery and Hand Surgery, 2021
Cecilia Dahlbäck, Rüdiger Baumeister, Magnus Åberg, Björn Arnljots, Lieselotte Frost Arner, Håkan Brorson
In the neck region, lymph vessels draining lymph toward the left venous angle were identified to receive the lymph fluid from the arm. Temporarily, a moistened silicon tube was placed within the subcutaneous tissue between the two incisions. The grafts could then be pulled without friction from the upper arm towards the neck. After removal of the tube, the grafts were anastomosed without tension to the ascending lymphatic main collectors at the upper arm. In the neck, the central endings of the grafts were anastomosed to lymphatic collectors running towards the left venous angle. The end-to-end anastomoses were created with single stitches in the so-called tension-free technique [4]. using Vicryl 10-0 (Ethicon®, USA) and a BV 75-4 needle. With this procedure, the area of the axilla and the origin of the fistula were bypassed and the influx into the fistula was impeded while securing the lymphatic transport from the arm.
Indocyanine green nanoparticles undergo selective lymphatic uptake, distribution and retention and enable detailed mapping of lymph vessels, nodes and abnormalities
Published in Journal of Drug Targeting, 2018
John C. Kraft, Piper M. Treuting, Rodney J. Y. Ho
Leveraging the ability of ICG particles to be retained in lymph vessels with minimal penetration into nearby tissues (Figures 2 and 3), as well as undergo extensive lymphatic first-passage throughout the lymphatic network of vessels and nodes following SC administration (Figure 3), we determined if the small lymph vessel connecting the subiliac and axillary LNs could be visualised. As schematically presented in Figures 1(C) and 4(A insert), ICG particles clearly delineated this lymph vessel adjacent to blood vessels, which were devoid of ICG signal (Figure 4(A)). This small mouse lymph vessel is estimated to be ∼0.2 mm in diameter (Figure 4(A)). This lymph vessel was not visible in mice treated with control free ICG. In addition, the high degree of lymphatic resolution from ICG particles detected a lymph vessel abnormality in a 23-month old mouse that was resolved down to a level of approximately 5–10 cells in two dimensions via histopathology (Figure 4(B)). This abnormality was verified by histopathology to be an enlarged lymph vessel with significant perivascular mononuclear cell infiltrations (Figure 4(B insert)). Collectively, these data verify that ICG particles rapidly clear from the SC space, are preferentially taken up into the lymphatics from the SC space, and undergo widespread distribution and retention within the lymphatic system throughout the body prior to entering the blood at the lymph–blood anastomoses near the heart. These properties enabled delineation of small normal and lesioned lymph vessels.