Welcome!
This website has a singular purpose. It aims to promote understanding and highlight the importance of the Lymphatic System. It also seeks to educate about new diagnostic and therapeutic options for the Lymphatic System disorders.
Why the Lymphatic System is important:
It works together with the vascular system as the conduits of the fluid in the body. The vascular system (arteries and veins) delivers fluids and essential nutrients to the tissues. Meanwhile, the lymphatic system removes fluid, some metabolites, and proteins from the tissues back into venous circulation.
Additionally, the lymphatic system has an immune role, reflected in its active participation in infectious and cancer processes. Nevertheless, this role has already received significant attention and is out of the scope of this website.
The lymphatic system is found throughout the body. Despite its importance, clinical medicine overlooked it for the last half of the century. The reason for this is that it is very difficult to see inside the body. When an average person (and majority of the doctors) thinks about the lymphatic system, they imagine lymphedema and swollen neck lymph nodes, because these are the parts we can see.
However, the major parts of the lymphatic system are located deep inside the body, in organs like liver and intestine, which generate 80-90% of the lymphatic flow in the main aqueduct of the lymphatic system-thoracic duct.
Why is it so difficult to image the “deep” lymphatic system? This is due to the very small size of the lymphatic vessels, extreme complexity and variability of the anatomy, and difficulty of introduction of the contrast. In addition, there were very few therapeutic options.
Everything started to change approximately 25 years ago, when Dr. Constantine Cope , one of the fathers of Interventional Radiology, conceptualized and tested a new procedure: thoracic duct embolization, at the Hospital of University of Pennsylvania. This development started a new page in our exploration and understanding of the contribution of the lymphatic system to variety of pathophysiological processes in the body.
This procedure gave us newfound ability to intervene in the lymphatic system, generating a new interest in imaging of the lymphatic system. Until recently, the only two imaging techniques of the lymphatic vessels were: pedal lymphangiography and lymphoscintigraphy— both were inferior for imaging of the central lymphatic system.
Approximately 5-6 years ago, new techniques for imaging the lymphatic system were developed. They include:
- Intranodal lymphangiography (IL)
- Dynamic Contrast-Enhanced Lymphangiography (DCMRL)
- Liver lymphangiography
- Mesenteric lymphangiography, and more.
All these techniques allowed for the discovery of the pathophysiology of a multitude of diseases, such as:
- Chylothorax
- Chylous ascites
- Plastic bronchitis
- Protein-losing enteropathy
- Genital lymphorrhea and swelling
- Pulmonary insufficiency in patients with lymphatic anomalies
In addition to these new imaging techniques, several interventional techniques were developed. They include:
- Thoracic duct embolization
- Liver lymphatic embolization
- Interstitial lymphatic embolization
- TD externalization
- TD stenting