Lymphatic oedema is characterised from all other oedemas, in both primary and secondary forms, by a high concentration of proteins in the spaces of the tissues affected by the disease. This results in a more or less hardening of the tissue related to the action that the proteins exert on the fibroblasts inducing them to produce collagen fibres and consequently sclerosis of the tissues themselves. The primary form arises due to an incomplete development of lymphoglandular pathways or stations, which results in an imbalance between the lymph produced in a certain anatomical region and its regular transport. In the secondary forms, this occurs due to an alteration in a lymphatic system that was originally normally developed and functioning (removal of lymph nodes or radiotherapy constitutes the most frequent causes that generate secondary lymphedema). Knowing these aspects also better directs the therapeutic action which, for example, does not normally make use of diuretics as these remove only the aqueous component and not the proteins from the tissues, worsening, in some cases, the clinical picture itself.

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Physiology and Pathophysiology of the Lymphatic System

  • Sandro Michelini,
  • Marina Cestari,
  • Serena Michlini

摘要

Lymphatic oedema is characterised from all other oedemas, in both primary and secondary forms, by a high concentration of proteins in the spaces of the tissues affected by the disease. This results in a more or less hardening of the tissue related to the action that the proteins exert on the fibroblasts inducing them to produce collagen fibres and consequently sclerosis of the tissues themselves. The primary form arises due to an incomplete development of lymphoglandular pathways or stations, which results in an imbalance between the lymph produced in a certain anatomical region and its regular transport. In the secondary forms, this occurs due to an alteration in a lymphatic system that was originally normally developed and functioning (removal of lymph nodes or radiotherapy constitutes the most frequent causes that generate secondary lymphedema). Knowing these aspects also better directs the therapeutic action which, for example, does not normally make use of diuretics as these remove only the aqueous component and not the proteins from the tissues, worsening, in some cases, the clinical picture itself.