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Review
. 2018 Feb;32(1):5-11.
doi: 10.1055/s-0038-1635118. Epub 2018 Apr 9.

Anatomy of the Lymphatic System and the Lymphosome Concept with Reference to Lymphedema

Hiroo Suami  1 , Mario F Scaglioni  2
Affiliations
Review

Anatomy of the Lymphatic System and the Lymphosome Concept with Reference to Lymphedema

Hiroo Suami et al. Semin Plast Surg. 2018 Feb.

Abstract

Precise knowledge of the lymphatic system normal anatomy is essential for understanding what structural changes occur in patients with lymphedema. In this article, the authors first review previous anatomical studies and summarize the general anatomy of the lymphatic system and lymphatic pathways in the upper and lower extremities. Second, they introduce their new anatomical concept, the "lymphosome," which describes how the lymphatic vessels in a particular region connect to the same subgroup of regional lymph nodes. In addition, they describe the anatomical relationship between the perforating lymphatic vessels and arteries. In the last section, they explain the anatomical changes in the lymphatics after lymph node dissection, with reference to secondary lymphedema.

Keywords: lymph capillary; lymph collecting vessel; lymphosome; precollector; sentinel node.

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Conflict of interest statement

Conflict of Interest None.

Figures

Fig. 1
Fig. 1
Schematic diagram of the lymphatic system. (Adapted from Suami et al. Reproduced with permission.)
Fig. 2
Fig. 2
Photos of an upper limb in a cadaver injected with dye into the collecting lymph vessels.
Fig. 3
Fig. 3
Schematic diagram of the lymphatic system in the upper half of the body. An arrow points to the sentry lymph node of the upper extremity. (Color of the lymphatics added to the original diagram from Jossifow. 8 )
Fig. 4
Fig. 4
Photos of a lower limb in a cadaver injected with dye into the collecting lymph vessels.
Fig. 5
Fig. 5
Schematic diagram of the lymphatic system in the inguinal region. Arrows point to the sentry lymph nodes of the lower extremity. (Color of the lymphatics added to the original diagram from Jossifow. 8 )
Fig. 6
Fig. 6
Lymphosomes of the body. The lymphatic territories are demarcated according to their corresponding lymphatic basins: 1. temporal, 2. occipital, 3. submental, 4. subclavicular, 5. subscapular, 6. lateral axillary, 7. pectoral, 8. superior inguinal, 9. lateral inguinal, 10. inferior inguinal, 11. popliteal. (Reproduced with permission of Hiroo Suami, 2018.)
Fig. 7
Fig. 7
Our representation of the three types of lymphatic drainage: superficial, deep, and perforating lymphatic systems. (Adapted from Suami et al. Reproduced with permission.)
Fig. 8
Fig. 8
ICG lymphography staging scale. (Adapted from Nguyen et al. Reproduced with permission.). ICG, indocyanine green.
See this image and copyright information in PMC

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