MORPHOLOGICAL ANALYSIS OF THE LYMPHATIC DRAINAGE OF THE ASCiTIC FLUID AND THE METASTATIC MECHANISM OF PERITONEAL

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Absorptive pathway via the lymphatic vessels system in the parietal peritoneum is clinically important for understanding lymphatic metastasis in the abdominal and pelvic cavities. Moreover, morphological characteristics of lymphatic networks in the prietal peritoneum have not yet been clarified. Previously we demonstrated enzyme-histochemically the structural organization of the lymphatics and blood capillary in several mammalian tissues. The present study is to describe the structure and distribution of the parietal peritoneal lymphatics in the whole-mount preparations or OCT frozen sections using histochemical method 5'-nucleotidase (5'-Nase) -alkaline phosphatase (ALPase) and intraperitoneal injection with ultra-fine carbon particles (CH-40, 21nm). Fifteen Japanese monkeys (Macaca fuscata) were used in this study. The whole-mount preparation with 5'-Nase -ALPase double staining enabled us to differentiate clearly lymphatic capillaries from the blood capillaries. Well-developed 5'-Na … More se-positive lymphatic networks were locally observed in the transitional area from the diaphragm to the peiitoneal regions and in the perirenal fat region. These tubo-saccular lymphatics were characterized by an irregular mesh-like network. The number of peritoneal lymphatics and their networks in the anterior and anterolateral regions rapidly decreased as compared with that in the foregoing regions. In the rectovesical and rectouterina (Douglas pouch) pouches, a tree-like network consisting of the tubulo-saccular lymphatics was observed. Numerous knob-like endings appeared at the apical parts of the initial lymphatics in the anterior peritoneal region. In Douglas pouch, a fine dense lymphatic network was well-developed around the suspensory ligament of ovary. The present study has first demonstrated enzyme-histochemically the precise distribution of 5'-Nase-positive lymphatic vessels in the monkey parietal peritoneum. These findings suggest a possibility that the peiitoneal lymphatic networks, as an additional pathway may clinically play an important role in absorption of ascitic fluid and particulate matter from the peritoneal cavity. Less