Mapping the Anatomy of the Human Lymphatic System

Author:

Bustos Valeria P.1,Wang Robin2,Pardo Jaime1,Boppana Avinash3,Weber Griffin4,Itkin Max5,Singhal Dhruv1

Affiliation:

1. Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts

2. Department of Radiology, Stanford University School of Medicine, Stanford, California

3. Revela Inc., Woburn, Massachusetts

4. Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts

5. Nemours Children's Hospital, Penn Medicine, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania

Abstract

Abstract Background While substantial anatomical study has been pursued throughout the human body, anatomical study of the human lymphatic system remains in its infancy. For microsurgeons specializing in lymphatic surgery, a better command of lymphatic anatomy is needed to further our ability to offer surgical interventions with precision. In an effort to facilitate the dissemination and advancement of human lymphatic anatomy knowledge, our teams worked together to create a map. The aim of this paper is to present our experience in mapping the anatomy of the human lymphatic system. Methods Three steps were followed to develop a modern map of the human lymphatic system: (1) identifying our source material, which was “Anatomy of the human lymphatic system,” published by Rouvière and Tobias (1938), (2) choosing a modern platform, the Miro Mind Map software, to integrate the source material, and (3) transitioning our modern platform into The Human BioMolecular Atlas Program (HuBMAP). Results The map of lymphatic anatomy based on the Rouvière textbook contained over 900 data points. Specifically, the map contained 404 channels, pathways, or trunks and 309 lymph node groups. Additionally, lymphatic drainage from 165 distinct anatomical regions were identified and integrated into the map. The map is being integrated into HuBMAP by creating a standard data format called an Anatomical Structures, Cell Types, plus Biomarkers table for the lymphatic vasculature, which is currently in the process of construction. Conclusion Through a collaborative effort, we have developed a unified and centralized source for lymphatic anatomy knowledge available to the entire scientific community. We believe this resource will ultimately advance our knowledge of human lymphatic anatomy while simultaneously highlighting gaps for future research. Advancements in lymphatic anatomy knowledge will be critical for lymphatic surgeons to further refine surgical indications and operative approaches.

Funder

U.S. Department of Health and Human Services

National Institutes of Health

Office of Strategic Coordination

Common Fund

National Heart, Lung, and Blood Institute

Publisher

Georg Thieme Verlag KG

Reference18 articles.

1. The physiology of the lymphatic system;M A Swartz;Adv Drug Deliv Rev,2001

2. Lymphatic vessel network structure and physiology;J W Breslin;Compr Physiol,2018

3. Pathophysiology of the lymphatic system in patients with heart failure: JACC state-of-the-art review;M Itkin;J Am Coll Cardiol,2021

4. The lymphatic system: a historical perspective;M Loukas;Clin Anat,2011

5. Anatomía del sistema linfático del miembro superior;J Latorre;An Cir Card y Vasc,2004

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