Japanese Journal of Clinical Oncology, Vol 28, Issue 2 104-106, Copyright © 1998 by Foundation for Promotion of Cancer Research
K Yamagata, K Kumagai, K Shimizu, K Masuo, Y Nishida and A Yasui
Primary gastrointestinal cancer frequently spreads to the mesentery,
omentum and other parts of the peritoneum and these deposits are generally
considered to be induced by intraperitoneal seeding from the primary
lesion. In this work, we examined the spread of gastrointestinal cancer
from the viewpoint of lymphogenous metastasis using a rat model of
mesenteric lymph vessel obstruction. With these models, we carried out
mesenteric lymphangiography on the fourth and sixth postoperative days
(five animals each) to examine morphological changes in the lymph vessels
and lymph flow. In model animals with mesenteric lymph vessel obstruction,
re-celiotomy, performed on the fourth postoperative day, revealed marked
mesenteric edema and enlargement of the mesenteric lymph nodes, suggestive
of lymph retention. We also carried out mesenteric lymphangiography and
obtained images of extensive mesenteric lymph vessels and reflux of lymph
distal to the obstruction point in all five animals. On the sixth
postoperative day, we obtained lymphangiographic images of
lymphatico-venous communication in the mesentery in all five animals. Thus
in animals with lymph vessel obstruction, the lymph flow appeared to change
to lymphatico-venous communication or reverse lateral flow. In clinical
cases, it is conceivable that lymph retention and reflux of lymph induced
by lymph vessel obstruction sometimes play a role in the mechanism of
intraperitoneal cancer dissemination and hematogenous metastasis.
ORIGINAL ARTICLE
Gastrointestinal cancer metastasis and lymphogenous spread: viewpoint of animal models of lymphatic obstruction
Department of Surgery, Showa University, Toyosu Hospital, Tokyo, Japan.
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