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Lymphatics and bone.

James R Edwards1, Kelly Williams, Lars G Kindblom

  • 1Department of Pathology, Nuffield Department of Orthopaedic Surgery, University of Oxford, Nuffield Orthopaedic Centre, Oxford, OX3 7LD, UK.

Human Pathology
|October 2, 2007
PubMed
Summary
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Lymphatic vessels are generally absent in normal bone and most bone tumors. Their presence in bone tumors correlates with extension through the bone cortex, suggesting limited role in bone fluid transport or metastasis.

Area of Science:

  • Bone biology
  • Tumor microenvironment
  • Lymphatic research

Background:

  • The presence and function of lymphatic vessels in bone remain controversial.
  • Morphological identification of lymphatics in bone tissue and tumors is challenging.

Purpose of the Study:

  • To investigate the presence of lymphatic vessels in normal bone and various bone neoplasms.
  • To determine the role of lymphatics in bone fluid transport and tumor progression.

Main Methods:

  • Immunohistochemistry using lymphatic endothelial cell markers (LYVE-1 and podoplanin).
  • Analysis of normal bone, primary bone tumors, and secondary carcinomas confined to or extending through bone.

Main Results:

  • Lymphatic vessels were not found in normal cortical or cancellous bone, but present in periosteal connective tissue.

Related Experiment Videos

  • Most primary and secondary bone tumors confined to bone lacked lymphatic vessels, except for lymphangioma, Gorham-Stout disease, and hemangioendothelioma.
  • Tumors extending through the bone cortex showed lymphatic vessels, potentially from surrounding tissues. Osteosarcomas with metastases contained intratumoral lymphatics.

    • Conclusions:

    • Lymphatic circulation is unlikely to be involved in normal bone fluid transport.
    • Lymphatic vessels are absent in most bone tumors confined within the bone cortex.
    • Lymphangiogenesis is not a significant factor in the progression of most primary bone tumors, and bone metastasis does not primarily occur via lymphatics.