European Group of Lymphology. The official journal of this Scientific Association is the “European Journal of Lymphology and Related Problems” (EJLRP).

 

Most clinical pictures with a main “gravitational reflux” component are due to lymphatic and chyliferous vessel dysplasia, with wall-valvular and/or lymph node insufficiency. Sometimes, these diseases may be iatrogenic, for example due to the ligature of the thoracic duct or to lesions of retroperitoneal lymphatic and chyliferous vessels. These complex clinical conditions, that may present with chyloperitoneum, chyledema of the lower limbs or of external genitalia, chyluria, chylothorax, chylometrorrhea, chylous effusion in a joint, in various mutual associations, often require complex diagnostic and therapeutical processes.

Severe chylous reflux with verrucoid lesions and chylorrhea in the scrotal-perineal region.

At lymphoscintigraphy, a gravitation reflux in the scrotal region and in the lower extremities is visible.

Lymphatic-chylous reflux at the level of the scrotum and the lower extremities with scrotal chylolymphostatic verrucosis.

 

The right counterpart of the thoracic duct, which, as is well known, empties at the level of the left subclavian-jugular angle, at the confluence of the left subclavian vein and the left internal jugular vein. In the majority of people, this vessel has a diameter of less than 5 mm and, often, it is totally absent. However, in a limited number of people, it may be even bigger than the thoracic duct, in which cases it may offset any thoracic duct insufficiency.

 

Protein molecules, produced by eukaryotic organisms, capable, through different mechanisms, of stimulating growth and differentiation of various tissues. VEGF-C or VEGF-2 (Vascular Endothelial Growth Factor-C or -2) have been identified as specific lymphatic endothelium growth factors. They exert their action by means of endothelial cell-specific receptor tyrosine-kinases, such as flk1/kDR, flt1, and flt4. Several experimental studies are currently under way to reproduce lymphangiogenesis both in vitro and in vivo, in order to better understand any tumor metastasis implications and their role in lymphatic-lymph node dysplasia.