Studies on the architectural change of lymphatic vessels in human liver cirrhosis

Abstract

The purpose of this study is to elucidate an architectural change of hepatic lymphatic vessels in human liver cirrhosis, and to investigate the relationship between the change of hepatic lymphatics and ascites production. Thirty-eight cirrhotic livers from pathological autopsy of our and affiliated institutions were submitted for this study. Macroscopically recognizable capsular lymphatics were injected with barium contained 5% gelatin solution using 30G sized lymphangiographic needle under manual pressure. The results obtained were as follows. In the cirrhotic liver, (1) decrease of mesh-like networks of hepatic lymphatic capillaries (HLC) and collecting tubes of HLC (HCT) was a remarkable finding especially on the protruded capsular surface of the pseudolobules of hepatic capsule. On the other hand, an increased number of hepatic lymphatic vessels (HLV) and hepatic lymphatic trunks (HCT) was seen in the depressed interpseudolobular stroma. (2) HLV around pseudolobules were destributed irregularly and sparsely, and formed irregular loop structures. Most of HLV were flattened at the protruded surface of pseudolobules, on the contraly, a number of HLV was found gatheredly in the interpseudolobular stroma. (3) Most of HLT showed almost normal running pattern, however, in accordance with the progression of hepatic atrophy in the liver cirrhosis, their zigzagged running pattern became predominant. This finding was seemed to be morphologically compatible with the outflow block of hepatic lymph. (4) Fine lymph vessels were recognized in some of lymph cysts. Discussions were made on the pathogenesis of lymph cysts and on relationship between lymph cysts and ascites production. (5) No lymphatic vessels were detected in tumor nodules of hepatocellular carcinoma associated with liver cirrhosis.