Date of Award

2021

Degree Type

Thesis

First Advisor

Shelley DiCecco

Second Advisor

Francis E. Jenney

Third Advisor

Lori Redmond

Abstract

INTRODUCTION: According to the Centers for Disease Control and Prevention, cardiac and pulmonary disease consistently rank on the top leading causes of death in the United States. Therefore, the different pathologies of the heart and lungs are studied extensively in the medical community. Current research hints at the possible association between the lymphatic system's dysfunction and cardiopulmonary disease's pathological progression. However, the effect of cardiopulmonary disease on the lymph nodes is not well known. A better understanding of the possible pathological changes to the lymphatic system associated with cardiopulmonary disease could help guide medical interventions.

OBJECTIVE: This study aims to investigate the effect of cardiopulmonary disease on lymph node size and structure.

METHODS: Cadaveric dissections to quantify lymph nodes were performed on 9 cadavers at Philadelphia College of Osteopathic Medicine Georgia Campus. The demographics of the cadavers are 6 female, 3 male, 8 Caucasian, 1 Indian, with an age range of 58-95 with a mean of 70. The study utilized anatomical landmarks to identify and extract lymph nodes. The cadavers were dissected for lumbar, common iliac, internal iliac, external iliac, superficial inguinal, deep inguinal, pulmonary, pectoral, parasternal, infraclavicular, central, humeral, subscapular, anterior neck, lateral neck, and cardiac lymph nodes. Cadavers were separated into two groups based on inclusion criteria for cardiopulmonary disease. Inclusion criteria included respiratory failure, atherosclerosis heart disease of native coronary artery, and organic heart disease.

RESULTS: First, the team examined to see if there was a difference in the number of lymph nodes found per different regions of the body when comparing the cardiopulmonary group versus non-cardiopulmonary group. Any P value of less than 0.05 was deemed significant. Mann-Whitney U test between cardiopulmonary group versus non-cardiopulmonary group yielded a P value of 0.1035. Next, an assessment of the distribution of two-dimensional area of lower body regions and upper body regions were done. Deep Inguinal region had a P-value of 0.0146 for one tailed test and internal iliac region had a P-value of 0.0191 for one tailed test. P-value for pectoral region was 0.0111 for a one tailed test. All other regions were not statistically significant in their difference. Lastly, qualitative analysis of lymph node histology between diseased states did not yield any conclusive differences.

CONCLUSION: Increase in two-dimensional area of deep inguinal, pectoral, and internal iliac lymph nodes suggest a possible relationship between cardiopulmonary disease state and lymphatic changes.

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