Abstracts LymphForsch 1/2016

– full text in German –

Tumor-associated lymphangiogenesis in malignancies of the eye

J. M. Mor,  L. M. Heindl. LymphForsch 20 (1) 2016:6-11

Summary
Malignancies of the ocular surface tend to induce tumor-associated lymphangiogenesis. This was demonstrated for three of the most common tumor entities of the eye, and an association of tumor-associated lymphatics with a range of prognostic parameters was shown. The purpose of the present review was to outline the prognostic significance oftumor-associated lymphangiogenesis and to discuss possible future therapeutic targets. The study comprised a PUBMED literature review and our own clinical results.
In ciliary body melanoma with extraocular extension, squamous cell carcinoma of the conjunctivaand conjunctival melanoma, tumor-associated lymphangiogenesis has beendemonstrated. This lymphangiogenesis is driven by multiple mediators of the tumor’smicroenvironment such as VEGF-C and -D as well as their receptor VEGFR-3. In immunohistochemicalanalyses, invasive tumor cells were detected in proliferating tumor-associated lymphatic vessels in all three of these tumor entities thereby permitting tumor cells access to the lymphatic system. In several studies, intratumoral lymphatic vessel density correlated with patients‘ recurrence-free survival, metastasis-free survival and overall survival. Hence, tumor-associated lymphatic vessel density gains relevance as a prognostic marker in these malignancies. Therapeutic approaches with established and new specific angiogenesis inhibitors must be subjected to detailed testing in future studies. Initial results are promising, however. In ciliary body melanoma with extraocular extension, squamous cell carcinoma of the conjunctiva, and conjunctival melanoma, the evaluation of tumor-associated lymphangiogenesis should be included in general pathology work-up. However, before specific antilymphangiogenic therapies can be introduced into clinical practice, further studies have to be conducted.

Keywords: ciliary body melanoma, tumor, tumor-associated lymphangiogenesis, extraocular
extension, conjunctiva, prognosis, VEGF
E-mail: ludwig.heindl@uk-koeln.de

Lymphological multilayer bandages – The significance of compression components and prescribing them in conformance with regulations

T. Hirsch. LymphForsch 20 (1) 2016:12-16

Summary
In addition to manual lymph drainage as part of combined physical decongestive therapy (CDT Phase 1), an essential component of therapy is the prescription by a physician of an appropriate lymphological compression bandage. Because prescribing so-called lymph sets is often difficult, it is very important for physicians to be familiar with the materials that are available and conform to the statutory regulations for drugs and medical aids. Compression underwrap increases the stiffness of the bandaging. Individually cut-to-size foam rubber pads improve the contact pressure of the bandaging and enable even application of pressure. The components also contribute to long-lasting compression effects and improved skin tolerance without requiring additional padding.

Keywords: combined physical decongestive therapy (CDT), lymphological compression bandage, multilayer bandage, components, stiffness
E-mail: info@gefaessmedizin-hirsch.de

Lipedema and lipo-lymphedema – a matter of lifestyle? Results of the first Germany-wide online survey on the quality of life of affected women – Part 1: Background, prevalence, medical treatment and therapy

N. Schubert, H. Viethen. LymphForsch 20 (1) 2016:18-27

Summary
Lipedema describes a chronic and progressive disease primarily characterized by a disproportionate and painful increase in subcutaneous adipose tissue accompanied by a tendency to develop hematoma. The cardinal symptom of the disease is a significant increasein subcutaneous fatty tissue of the extremities, with the acra and trunk not affected. In the further progression, lipo-lymphedema develops. The etiology of the disease is unknown to date. In Germany, lipedema is estimated to affect 3,295,000 women (8 % of 41,188,000 women). Medical personnel or therapists‘ lack of knowledge about or failure to recognize the disease often leads to the condition going undiagnosed for a period of years or it being mistaken for lifestyle-related obesity. The survey reported on here indicates that this may exacerbate suffering on the part of women with lipedema.
Keywords: lipedema, lipohyperplasia dolorosa, life style-related obesity, subject-specifictherapeutic education, lipo-lymphedema, secondary lymphedema

E-mail: lipoedem.umfrage@gmail.com