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Development of the Lymphatic System

Development of the Lymphatic System

The development of lymphatic tissues and vessels in embryonic life begins around the fifth week. These structures originate from the mesoderm layer, with lymph sacs emerging from developing veins.
The first lymph sacs to form are the paired jugular lymph sacs located at the junction of the internal jugular and subclavian veins. From these sacs, lymphatic capillary plexuses extend to the thorax, upper limbs, neck, and head, eventually forming lymphatic vessels. Each jugular lymph sac maintains a...

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Isolation of Human Lymphatic Endothelial Cells by Multi-parameter Fluorescence-activated Cell Sorting

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Spontaneously Resolved Macrocystic Lymphatic Malformations: Predictive Variables and Outcomes.

Michael J Phang¹, Douglas J Courtemanche^1,2, Marija Bucevska¹

¹University of British Columbia, Vancouver, British Columbia, Canada.

Plastic Surgery (Oakville, Ont.)

|October 14, 2017

Summary

Spontaneous resolution of macrocystic lymphatic malformations occurred in 11.5% of cases, often following infection. Observing these lesions for up to 24 months may be a viable alternative to treatment.

Keywords:

macrocystic lymphatic malformations treatment

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Area of Science:

Vascular Surgery
Pediatric Surgery
Dermatology

Background:

Lymphatic malformations are benign vascular anomalies typically presenting at birth.
Nonoperative treatment with sclerotherapy is the standard therapy due to surgical morbidity.
Spontaneous resolution of macrocystic lymphatic malformations has been observed in some patients.

Purpose of the Study:

To review features of patients with macrocystic lymphatic malformations that may contribute to spontaneous resolution.
To identify potential predictors for spontaneous resolution in pediatric patients.

Main Methods:

Retrospective chart review of patients with macrocystic lymphatic malformations from a Vascular Anomalies Clinic database (1999-2014).
Analysis of patient characteristics associated with spontaneous resolution of lesions.

Main Results:

Seven out of 61 patients (11.5%) with macrocystic lymphatic malformations experienced spontaneous resolution.
Spontaneous resolution was associated with antecedent local or upper respiratory tract infections in 6 out of 7 cases.
Lesions were predominantly located in the neck (6/7) and presented after birth (median age 2 years).

Conclusions:

Upper respiratory tract or local infections may precede spontaneous resolution of lymphatic malformations.
The observed proportion of post-natal presentation and neck region location is higher than in other series.
Observational management for up to 24 months may be considered for asymptomatic or minimally disfiguring lesions, particularly those presenting after birth or in the neck.