Abstracts LymphForsch 2/2017

– full text in German –

Implantation of tissue-engineered lymph nodes using polycaprolactone scaff olds in immunodeficient nude mice

M.-S. D. Kwak, E. R. Balmayor, J.-T. Schantz, M. P. Chhaya, D. W.
LymphForsch 21 (2) 2017;68-73

Summary:
Treatment of chronic lymphedema is clinically challenging and healing is still only possiblei n some rare cases. Besides the gold standard of complex decongestive therapy (CDT), reconstructive surgical techniques are used, with microvascular lymph node transplantation the most promising procedure. We introduced the technique, which was first described by Becker et al. several decades ago, in our department in February 2011. The procedure entails harvesting of a fat/lymph node package from the healthy donor site for microsurgical transplantation into the aff ected recipient site. It is hypothesized that growth factors released by transplanted lymph node tissue induce lymphangiogenesis in the surroundingtissue. One major drawback is the development of iatrogenic lymphedema at the donor site. We use a novel scaff old-based lymph node tissue engineering concept to minimizethe surgical risks and simultaneously induce lymph vessel regeneration in the recipientsite. For the procedure, a healthy lymph node is surgically harvested and sliced into small fragments. These are combined with fi brin glue and loaded into a polycaprolactone scaff old, which is designed for tissue engineering applications by a 3D printing process (melt electrospinning writing). The cylindrical bio-absorbable scaff old can be used for in vitro cultivation experiments or for immediate in vivo transplantation. Our initial results in the mouse model indicate the development of new lymphatics emerging from the transplant. We demonstrate that lymph node tissue engineering has the potential to become an important foundation for the treatment of chronic lymphedema.

Keywords: lymphangiogenesis, lymphatic vessels, artifi cial lymph nodes, scaff old, tissue engineering, polycaprolactone, microvascular lymph node transplantation, lymph node fragments
E-mail: ms.kwak@tum.de

Podoconiosis – a nonfilarial elephantiasis: An encounter with a strange disease in Uganda

R. H. Kraus, M. N. Kraus
LymphForsch 21 (2) 2017;74-77

Summary:
Two members of the German Association for the Promotion of Lymphedema Therapy (Verein zur Förderung der Lymphoedemtherapie e.V.) investigated the living situation of patients with elephantiasis in various districts of Uganda. In one district, they observed numerous patients with massive lymphedema. In these cases, an international team of experts did not detect any fi larial antigens and also ruled out leprosy and skin diseases as causes of the edema. Since the aff ected individuals usually walk barefoot on the volcanic soil of the region, the experts suspect that the patients have podoconiosis.

Keywords: elephantiasis, geochemical lymphedema, podoconiosis
E-mail: kraus@lymphverein.de

Magnetic resonance lymphangiography for diagnosis and treatment of peripheral lymphedema

C. C. Pieper
LymphForsch 21 (2) 2017;78-85

Summary:
Magnetic resonance lymphangiography (MRL) is a non-invasive imaging technique that can be integrated in the diagnostic work-up of lymphedema. It yields high-resolution anatomical images of peripheral lymphatic vessels and nodes. Furthermore, the technique enables functional examination of lymphatic fl ow, as well as visualization of the extent and distribution of lymphedema, volumetry of the entire extremity and subcutaneous adipose tissue, along with detection of dermal backflow. Possible indications for the Imaging method include the assessment of clinically unclear cases, pre-surgical planning of (micro) surgery, and post-surgical follow-up.

Keywords: lymphedema, lymphangiography, magnetic resonance imaging, magnetic resonance lymphangiography
E-mail: claus.christian.pieper@ukbonn.de

Benign asymmetric lipomatosis Launois-Bensaude: A case report

A. Baumgartner, W. Schmeller
LymphForsch 21 (2) 2017;78-85

Summary:
While benign symmetric lipomatosis Launois-Bensaude has been described in the literature quite often, to the best of our knowledge an asymmetric form of this disease has never been reported previously. In this article we describe a first case.

Keywords: benign asymmetric lipomatosis, Launois-Bensaude Syndrome
E-mail: ab@hanse-klinik.com