Anatomy of the Lymphatic System and Its Structural Disorders in Lymphoedema
The anatomy of the lymphatic system is the least studied field in gross anatomical research. Our current knowledge about the normal anatomy of the lymphatic system still largely depends on dissection studies performed using the mercury injection technique in cadavers over 100 years ago. In addition, there has been insufficient investigation from the anatomical perspective of the pathophysiology of lymphoedema that develops congenitally or after cancer treatment. The recent development of a new cadaver dissection technique by the authors and use of indocyanine green fluorescence lymphography in the clinical setting have enabled us to visualise the anatomical structure of the lymphatic system and provide further understanding about normal lymphatic anatomy and the structural alterations that occur in lymphoedema.
I thank the Department of Neurobiology and Anatomy at the University of Texas Medical School at Houston for assisting in cadaver dissection studies and the Department of Plastic Surgery at the University of Texas MD Anderson Cancer Center for organising capital equipment. I thank Dianna Cody, Ph.D., from the Department of Imaging Physics MD Anderson Center for Advanced Biomedical Imaging for taking computed tomography images of cadaver specimens and Shun Yamazaki, M.D., at the Department of Plastic and Reconstructive Surgery, Ryukyu University Hospital, Okinawa, Japan, for composing 3D images and video from the imaging data in ◘ Fig. 5.8. I also thank Mr. Michael Gallagher for producing the professional medical illustration in ◘ Fig. 5.14 and Philippa Sutton at the Faculty of Medicine and Health Sciences, Macquarie University, for her professional editing of the manuscript.
Three-dimensional volume-rendering image of the upper extremity and torso lymphatic vessels (green) in a cadaver forequarter (Published with kind permission of © Hiroo Suami 2017) (WMV 7723 kb)
ICG fluorescence lymphography image in a cadaver upper extremity (WMV 73621 kb)
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