Conjunctival lymphangiectasia: a report of 11 cases and review of literature.

Mar 2012

Welch J, Srinivasan S, Lyall D, Roberts F.

Source

Department of Ophthalmology, Ayr Hospital, Ayrshire and Arran National Health Service, Ayrshire, Scotland, United Kingdom.

Abstract

Conjunctival lymphangiectasia is an uncommon clinical condition in which there is dilatation of lymphatic channels in the bulbar conjunctiva. Conjunctival lymphangiectasia is a rarely appreciated ocular surface disorder that typically occurs as a secondary phenomenon in response to local lymphatic scarring or distal obstruction.

Conjunctival lymphangiectasia can either be unilateral or bilateral with focal or diffuse bulbar chemosis. We present 11 cases of biopsy-proven conjunctivallymphangiectasia. Of the 11 cases, 3 presented with bilateral diffuse bulbar chemosis, 1 had diffuse unilateral chemosis, and the remaining 7 presented with focal (<90°) bulbar chemosis.

Three of these cases had co-existing pterygium, and one case presented with focal bulbar chemosis and a conjunctival keratin horn. All underwent surgical excision of the involved conjunctiva, either with no graft (n = 6), combined with amniotic membrane transplant (n = 3), or combined with conjunctival autograft (n = 2).

Survery of Ophthalmology

Embryonic development and malformation of lymphatic vessels.

Embryonic development and malformation of lymphatic vessels.

Novartis Found Symp. 2007

Wilting J, Buttler K, Rössler J, Norgall S, Schweigerer L, Weich HA, Papoutsi M.
Department of Pediatrics 1, Georg-August-University, Goettingen, Germany.

In the human, malformations of lymphatic vessels can be observed as lymphangiectasia, lymphangioma and lymphangiomatosis, with a prevalence of 1.2-2.8 per thousand. Their aetiology is unknown and a causal therapy does not exist. We investigated the origin of lymphatic endothelial cells (LECs) in avian and murine embryos, and compared the molecular profile of LECs from normal and malformed lymphatics of children. In avian embryos, Prox1+ lymphangioblasts are located in the confluence of the cranial and caudal cardinal veins, where the jugular lymph sac (JLS) forms. Cell lineage studies show that the JLS is of venous origin. In contrast, the lymphatics of the dermis are derived from mesenchymal lymphangioblasts located in the dermatomes, suggesting a dual origin of LECs in avian embryos. The same may hold true for murine embryos, where Lyve1+ LEC precursors are found in the cardinal veins, and in the mesenchyme. The mesenchymal cells express the pan-leukocyte marker CD45, indicating a cell type with lymphendothelial and leukocyte characteristics. In the human, such cells might give rise to Kaposi's sarcoma. Microarray analyses of LECs from lymphangiomas of children show a large number of regulated genes, such as VEGFR3. Our studies show that lymphvasculogenesis and lymphangiogenesis occur simultaneously in the embryo, and suggest a function for VEGFR3 in lymphangiomas.

PMID: 18300425 [PubMed - in process]

Lymphangiogenesis in Crohn’s disease: an immunohistochemical study using monoclonal antibody D2-40

Lymphangiogenesis in Crohn’s disease: an immunohistochemical study using monoclonal antibody D2-40
F. Pedica1 , C. Ligorio1, P. Tonelli2, S. Bartolini3 and P. Baccarini1
(1)
Section of Pathology, Bellaria Hospital, University of Bologna, Via Altura 3, 40139 Bologna, Italy
(2)
General Surgery 1, Department of Medicine and General Surgery, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy
(3)

Unity of Oncology, Bellaria Hospital, Bologna, Italy
Received: 17 September 2007 Revised: 24 October 2007 Accepted: 26 October 2007 Published online: 27 November 2007

Abstract

Crohn’s disease (CD) is a chronic inflammatory bowel disorder of unknown etiology. An involvement of the intestinal lymphatic system has been suggested. Recently, monoclonal antibodies have become available to distinguish lymphatic vessels from blood vessels. The aim of the study was to examine the distribution of lymphatic vessels in ileal and colic walls of patients affected by CD and compare it with healthy controls and other inflammatory bowel diseases. Twenty-eight cases of CD, 13 cases of other inflammatory bowel diseases, and 10 normal ileal and colic walls were studied. Immunohistochemical staining was performed using the monoclonal antibody D2-40. Quantification of lymphatic vessels was performed by identifying four fields with high density of lymphatics and then counting the number of lymphatic vessels at high resolution. Lymphatic diameter was also evaluated by using an ocular micrometer. Lymphatic vessels showed the highest density in CD specimens. The median number of lymphatics was significantly higher both in ileal and colic samples of CD than the other inflammatory diseases as well as normal controls. Moreover, in patients with CD, diffuse lymphangiectasia was also observed. The present data suggest that lymphangiogenesis and lymphangiectasia probably play a role in the pathogenesis of CD.

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