Location

Moultrie, GA

Start Date

7-5-2025 1:00 PM

End Date

7-5-2025 4:00 PM

Description

Introduction:

The thoracic duct (TD) is the primary lymphatic vessel responsible for transporting lymph into the venous system. Anatomical variants, including duplication, right-sided termination, and bifurcation, have been documented, though their clinical significance is not fully understood. Notably, studies indicate that the thoracic duct exhibits variant anatomy in approximately 40% of individuals, with multiple channels or partial duplications occurring in about 20% of cases. Bifurcation sites may experience unique structural and histopathological changes that contribute to dysfunction. However, little is known about how these sites may predispose individuals to lymphatic obstruction, fibrosis, and chylothorax.

Objective:

This study examines the variation in endothelial integrity of the thoracic duct (TD) by focusing on hematoxylin and eosin (HE) and trichrome staining to assess structural changes, including collagen dispersion, at branching sites. Specifically, we investigate whether endothelial integrity is compromised at bifurcation points, with attention to disruptions in endothelial continuity and alterations in collagen deposition. By comparing bifurcated and non-bifurcated TDs, we aim to identify any differences in the structural organization and integrity of the lymphatic endothelium.

Methods:

Cadaveric thoracic duct (TD) specimens were collected from post-mortem dissection, with one sample taken from the area containing multiple small branches and another from the non-branching portion serving as the control. Samples will be processed for H&E staining to evaluate cellular integrity, inflammation, and lymphatic dilation. Trichrome staining will assess collagen deposition and fibrosis at bifurcation points compared to non-bifurcated regions. Quantitative analysis of duct wall thickness, inflammatory cell infiltration, and fibrosis grading will be conducted.

Results:

We anticipate that samples with thoracic duct bifurcations will exhibit increased fibrosis, smooth muscle hypertrophy, and inflammatory infiltration, predisposing them to lymphatic dysfunction. Furthermore, structural abnormalities at these sites may correlate with a higher risk of chylothorax formation and lymphatic obstruction.

Discussion:

Findings from this study will provide novel insights into the structural vulnerabilities of the thoracic duct and their potential role in lymphatic pathology. This could improve diagnostic approaches, therapeutic interventions, and surgical management of lymphatic disorders such as chylothorax and lymphedema. These findings warrant further investigation into the clinical implications of TD bifurcations and whether they result from a failure in embryological remodeling rather than representing a benign anatomical variation.

Embargo Period

6-3-2025

COinS
 
May 7th, 1:00 PM May 7th, 4:00 PM

Histopathological changes at thoracic duct bifurcations: implications for lymphatic obstruction, fibrosis, and chylothorax risk

Moultrie, GA

Introduction:

The thoracic duct (TD) is the primary lymphatic vessel responsible for transporting lymph into the venous system. Anatomical variants, including duplication, right-sided termination, and bifurcation, have been documented, though their clinical significance is not fully understood. Notably, studies indicate that the thoracic duct exhibits variant anatomy in approximately 40% of individuals, with multiple channels or partial duplications occurring in about 20% of cases. Bifurcation sites may experience unique structural and histopathological changes that contribute to dysfunction. However, little is known about how these sites may predispose individuals to lymphatic obstruction, fibrosis, and chylothorax.

Objective:

This study examines the variation in endothelial integrity of the thoracic duct (TD) by focusing on hematoxylin and eosin (HE) and trichrome staining to assess structural changes, including collagen dispersion, at branching sites. Specifically, we investigate whether endothelial integrity is compromised at bifurcation points, with attention to disruptions in endothelial continuity and alterations in collagen deposition. By comparing bifurcated and non-bifurcated TDs, we aim to identify any differences in the structural organization and integrity of the lymphatic endothelium.

Methods:

Cadaveric thoracic duct (TD) specimens were collected from post-mortem dissection, with one sample taken from the area containing multiple small branches and another from the non-branching portion serving as the control. Samples will be processed for H&E staining to evaluate cellular integrity, inflammation, and lymphatic dilation. Trichrome staining will assess collagen deposition and fibrosis at bifurcation points compared to non-bifurcated regions. Quantitative analysis of duct wall thickness, inflammatory cell infiltration, and fibrosis grading will be conducted.

Results:

We anticipate that samples with thoracic duct bifurcations will exhibit increased fibrosis, smooth muscle hypertrophy, and inflammatory infiltration, predisposing them to lymphatic dysfunction. Furthermore, structural abnormalities at these sites may correlate with a higher risk of chylothorax formation and lymphatic obstruction.

Discussion:

Findings from this study will provide novel insights into the structural vulnerabilities of the thoracic duct and their potential role in lymphatic pathology. This could improve diagnostic approaches, therapeutic interventions, and surgical management of lymphatic disorders such as chylothorax and lymphedema. These findings warrant further investigation into the clinical implications of TD bifurcations and whether they result from a failure in embryological remodeling rather than representing a benign anatomical variation.