Open Access Medical Books

TEXTBOOK : NOVEL STRATEGIES IN LYMPHEDEMA

LYMPHEDEMA

Edited by Alberto Vannelli .

114 pages .
Open Access .

The human body has two circulatory systems. These are the cardiovascular system and the lymphatic system. They are part of the immune system comprising a network of conduits called lymphatic vessels that carry a clear fluid called lymph (from Latin lympha "water") towards the heart. There are many milestones in the history of the lymphatic system. The lymphoid system can be broadly divided into the conducting system and the lymphoid tissue. The conducting system carries the lymph and consists of tubular vessels that include the lymph capillaries, the lymph vessels, and the right and left thoracic ducts. The lymphoid tissue is primarily involved in immune responses and consists of lymphocytes and other white blood cells enmeshed in connective tissue through which the lymph passes. Regions of the lymphoid tissue that are densely packed with lymphocytes are known as lymphoid follicles. Lymphoid tissue can either be structurally well organized as lymph nodes or may consist of loosely organized lymphoid follicles known as the mucosa-associated lymphoid tissue (MALT). Lymph vessels called lacteals are present in the lining of the gastrointestinal tract, predominantly in the small intestine. While most other nutrients absorbed by the small intestine are passed on to the portal venous system to drain via the portal vein into the liver for processing, fats (lipids) are passed on to the lymphatic system to be transported to the blood circulation via the thoracic duct. (There are exceptions, for example medium-chain triglycerides are fatty acid esters of glycerol that passively diffuse from the gastrointestinal tract to the portal system.) The enriched lymph originating in the lymphatics of the small intestine is called chyle. As the blood circulates, fluid leaks out into the body tissues. This fluid is important because it carries food to the cells and waste back to the bloodstream. The nutrients that are released to the circulatory system are processed by the liver, having passed through the systemic circulation. The lymph system is a one-way system, transporting interstitial fluid back to blood. Lymphatics were discovered by chance, but were misunderstood for a very long time. Up to the early twentieth century the accurate description of lymphatics was deemed necessary to promote advances in oncology (Rouviere, 1932). The study of lymphatic drainage of various organs is important in diagnosis, prognosis, and treatment of cancer. The lymphatic system, because of its physical proximity to many tissues of the body, is responsible for carrying cancerous cells between the various parts of the body in a process called metastasis. The intervening lymph nodes can trap the cancer cells. If they are not successful in destroying the cancer cells the nodes may become sites of secondary tumours. As editor of this book it is my intention in this brief introductory chapter to provide a sampling of some of the varied topics related to the discipline of lymphology. Whetting the readers’ appetite for this subject will enable them to better enjoy the many superb multi-authored chapters written with an international perspective that follow..... 

Alberto Vannelli
Foundation IRCCS "National Institute of Cancer", Milan
Faculty Lecturer in lymphology, University of the Study of Milan,
Italy
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CONTENTS OF THE TEXTBOOK : 


Introduction : A Brief Overview of Lymphology:  Past, Present and Future 1 Alberto Vannelli

 1 Strategies in Modulating Lymphedema 13 Jin-Hong Chang, Joshua H. Hou, Sandeep Jain and Dimitri T. Azar

 2 Titanium and Yellow Nail Syndrome 23 Fredrik Berglund

 3 Arm Lymphedema as a Consequence of Breast Cancer Therapy 31 A. Gabriella Wernicke, Yevgeniya Goltser, Michael Shamis and Alexander J. Swistel

 4 Preparing for and Coping with Breast Cancer-Related Lymphedema 53 M. Elise Radina and Mei R. Fu

 5 Pelvic Lymphedema in Rectal Cancer 89 Alberto Vannelli and Luigi Battaglia


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