Changes in Paracardiac Lymph Nodes in Portal Hypertension

Abstract

Because of their proximity to the coronary vein and thoracic duct, the para cardiac lymph nodes are liable to develop both venous and lymphatic conges tion. The authors studied morphologic changes in the paracardiac lymph nodes in patients with portal hypertension.

Paracardiac lymph nodes were obtained during surgery from 40 volunteer patients with esophageal varices due to schistosomal portal hypertension (29 nonbleeders, 11 bleeders). Paracardiac lymph nodes from 10 volunteer patients having surgery for correction of incisional hernia served as controls.

The main histologic difference found in this study was the lower incidence of necrosis in nonbleeders. This indicates the possible role played by inadequate lymphatic drainage of the excessive lymph produced by the congested varices- bearing area in the bleeder.

Get full access to this article

View all access options for this article.

References

Sadeck AM , Aboul-Enein A. , Hassenein E. , et al: Thoracic duct changes in Schistosomal hepatic fibrosis. Gut 11:74-78, 1970.

Steinmann G. , Foldi E. , Foldi M. : Morphologic findings in lymph nodes after occlusion of their efferent lymphatic vessels and veins . Lab Invest 47:43-50, 1982.

Aboul-Enein A. : Pumping failure of the lymph versus thoracic duct outlet obstruction and their significance in ascites. Med Chir Dig 3:109-112, 1974.

Witte CL , Witte MH , Cole WR , et al: Dual origin of ascites in hepatic fibrosis. Surg Gynaecol Obstet 129:1027-1033, 1969 .

Aboul-Enein A. : Observations on the left supraclavicular lymph nodes in portal hypertension. Med Chir Dig 4:145-147, 1975.

Aboul-Enein A. : Changes of the abdominal lymphatics in ascitic patients with Schistosomal hepatic fibrosis. I. Cardiovasc Surg 14:529-534, 1973.

Pressman II , Siman UB : Experimental evidence of direct communications between lymph nodes and veins . Surg Gynec Obstet 113:537-541, 1961.

Tilak M. , Howard IM : The influence of the dual circulation on the viability of lymph nodes following interruption of their blood or lymphatic supply. Surg Gynec Obstet 119:349-352, 1964.