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Published on: May 1, 2015
Cytological and Biochemical Analyses of Lymphatic Fluid from Patients with Lymphatic Malformations
Jie Zhou1, Lei Guo1, Dan Song1
1Department of Vascular Anomalies and Interventional Radiology, Children's Hospital Affiliated to Shandong University, Jinan, China.
Insights
Bleeding lymphatic malformations (LMs) show altered lymphatic fluid composition, with higher IL-6, IL-10, glucose, and white blood cells. This indicates inflammation within the cyst, not a systemic cytokine storm.
Area of Science:
- Pediatric Surgery
- Biochemistry
- Immunology
Background:
- Intracystic hemorrhage is common in lymphatic malformations (LMs).
- Compositional changes in lymphatic fluid during hemorrhage are poorly understood.
Purpose of the Study:
- To investigate biochemical and cellular differences in lymphatic fluid from bleeding versus non-bleeding pediatric LMs.
Main Methods:
- Prospective collection of lymphatic fluid from children with LMs.
- Cytological and biochemical analyses of fluid from bleeding and non-bleeding groups.
- Statistical comparison using the Mann-Whitney U test.
Main Results:
- Significantly higher levels of interleukin (IL)-6, IL-10, glucose, and white blood cell percentage in bleeding LMs.
- No significant differences in protein, chlorine, white blood cell count, or other tested cytokines (IL-2, IL-4, TNF-α, IFN-γ).
Conclusions:
- Lymphatic fluid in bleeding LMs is less stable and prone to local inflammation.
- The observed inflammation is confined to the lymphatic fluid and does not trigger a systemic cytokine storm.
- Protein and chlorine levels remain unaffected by hemorrhage within the LM cyst.
Abstract:
Intracystic hemorrhage from lymphangiomas is a common phenomenon in lymphatic malformations (LMs); however, little is known about the associated compositional changes in the lymphatic fluid. We prospectively collected lymphatic fluid from children with LMs. Lymphatic fluid was divided depending on the bleeding status into the bleeding and nonbleeding groups. The fluid was subjected to cytological and biochemical analyses to determine protein and cytokine levels. The Mann-Whitney U test was used to compare the two groups. There were significant differences in the levels of interleukin (IL)-6, IL-10, and glucose, and the percentage of white blood cells between the bleeding and nonbleeding groups. There was no significant difference in chlorine and protein content; white blood cell count; and IL-2, IL-4, tumor necrosis factor α, and interferon γ levels between the two groups. Lymphatic fluid is less stable in bleeding LMs than in non-bleeding LMs and is prone to inflammatory reactions. The inflammatory reaction in lymphatic fluid does not stimulate the cytokine storm in blood. The inflammatory reaction due to LMs does not affect the contents of protein and chlorine in lymphatic cyst fluid.
