My Life with Lymphoma and Lymphedema - Part Three

April 30, 2006

Since my last updated in December much has happened in my ongoing struggle with lymphoma and lymphedema.

I have continued the Rituxan treatments, and hopefully that is helping blunt and/or remove the lymphoma. This will be continued every three weeks for the next two years.

There has however, been a dramatic change in the lymphedema. For the last couple months, I have experienced significant over-all body lymphedema.

This includes incredible difficulty in breathing, significant new swelling now in both arms, abdomen, chest and even back.

For many years, I tried to get my former oncologist to understand that B-cell lymphoma with hereditary lymphedema would not follow the same progression path and lymphoma by itself.

As all this new lymphedema has occured, I have wondered how much of it is lymphoma...how much is just the lymphedema.

I ran accross quite by accident today, the first clinical report I have been able to locate on B-cell lymphoma and its overall effect on the lymph system itself. For me it is stunning, as it is verifiable proof of what I have been saying for years.

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Density of intranodal lymphatics and VEGF-C expression in B-cell lymphoma and reactive lymph nodes.

Wroel T, Mazur G, Dziegiel P, Jelen M, Szuba A, Kuliczkowski K, Zabel M.

Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Medical University, Wroclaw, Poland.

wrobelt@hemat.am.wroc.pl

Lymphatic vasculature in solid tumors may serve as the pathway for metastatic spread of the cancer to the regional lymph nodes and to distant organs. Controversy still exists whether tumors metastasize through existing lymphatics or through newly formed vessels (lymphangiogenesis). The role of lymphangiogenesis in lymphoma spread and proliferation is not clearly established.

VEGF-C is the most potent inducer of lymphangiogenesis. LYVE-1 was shown to be a specific marker for lymphatic vessels in normal and tumor tissue. The aim of the present study was the evaluation of lymph node LYVE-1-positive lymphatic sinus density (LSD) and VEGF-C expression in patients with non-Hodgkin's lymphoma (nHL) and in reactive lymph nodes. Sixty paraffin-embedded lymph nodes from newly diagnosed patients with B-cell nHL were evaluated. Twelve lymph node biopsy specimens from adult patients with reactive lymphonodulitis were used as controls. Sections of lymph nodes were stained immunohistochemically for LYVE-1 and VEGF-C.

VEGF-C expression in lymph nodes of nHL patients was low and not significantly different from that in the control (p = 0.6). Moreover, VEGF-C expression did not differ significantly between aggressive and indolent lymphomas (p = 0.53). Similarly we did not find differences in LSD in aggressive nHL and in indolent nHL (p=0.49). The mean LSD in reactive lymph nodes was higher than in nHL (p = 0.03). Only in 2 out of 12 reactive lymph nodes LYVE-1-positive vessels were absent.

In all groups we demonstrated a strong positive correlation between VEGF-C and LYVE-1-expression (p = 0.0001). Higher LSD in reactive lymph nodes as compared to those of nHL patients suggests that lymphoma proliferation leads to the destruction of the existing lymphatics rather than to lymphangiogenesis within lymph nodes. NHL are not associated with increased expression of VEGF-C nor increased LYVE-1-positive lymphatic sinuses density within lymph nodes.

PMID: 16584091 [PubMed - indexed for MEDLINE

Related Pages:

My Life with Lymphoma and Lymphedema Part One

My Life with Lymphoma and Lymphedema Part Two

Lymphedema and Lymphoma - an Update