Lymphatics

18 pages, 311 KB

Open AccessReview

Physiologic Lymphedema Surgery: Current Treatments and Future Trends

by Ethan L. MacKenzie, Anne Huang, Min-Jeong Cho, Roman J. Skoracki and Rohini L. Kadle

Lymphatics 2025, 3(4), 35; https://doi.org/10.3390/lymphatics3040035 - 20 Oct 2025

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Lymphedema is a chronic, progressive, and debilitating disease of the lymphatic system with no current cure. Physiologic procedures, which address the underlying pathophysiology of lymphatic dysfunction, have gained traction in both treatment and prevention of lymphedema. This narrative review examines current physiologic lymphedema [...] Read more.

Lymphedema is a chronic, progressive, and debilitating disease of the lymphatic system with no current cure. Physiologic procedures, which address the underlying pathophysiology of lymphatic dysfunction, have gained traction in both treatment and prevention of lymphedema. This narrative review examines current physiologic lymphedema surgical techniques and emerging developments in this rapidly evolving field. While the two most common physiologic surgeries remain lymphovenous bypass (LVB) and vascularized lymph node transfer (VLNT), newer physiologic surgery techniques such as vascularized lymph vessel transfer (VLVT) and lymph node to vein anastomosis (LNVA) have been described in an effort to reduce donor site morbidity, with early promising clinical outcomes. The use of bioengineering with stem cells, pro-lymphangiogenic growth factors, and biomaterials such as Biobridge can be applied in conjunction with surgery to help promote lymphangiogenesis. Technological advances in robotic surgical systems and 3D exoscopes are helping to make supermicrosurgery more technically feasible and ergonomic, and increasing accessibility to lymphedema surgery. As our surgical armamentarium expands, treatment algorithms must be updated to determine how various surgical techniques can be combined and sequenced, how the indications for physiologic surgery can be expanded, and how surgical treatment can be tailored to the patient and disease process. Full article

9 pages, 219 KB

Open AccessReview

Personalized Frontline Therapy in Diffuse Large B-Cell Lymphoma: Integrating Circulating Tumor DNA for Real-Time Adaptive Treatment Stratification

by Vasisht Karri and Samir Dalia

Lymphatics 2025, 3(4), 34; https://doi.org/10.3390/lymphatics3040034 - 17 Oct 2025

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Abstract

This review analyzed approximately 115 peer-reviewed studies published between 2010 and 2025, focusing on molecular subtyping and circulating tumor DNA (ctDNA)-guided approaches in Diffuse Large B-Cell Lymphoma (DLBCL). Evidence was synthesized from retrospective cohorts, prospective clinical trials, and translational studies, highlighting how molecular [...] Read more.

This review analyzed approximately 115 peer-reviewed studies published between 2010 and 2025, focusing on molecular subtyping and circulating tumor DNA (ctDNA)-guided approaches in Diffuse Large B-Cell Lymphoma (DLBCL). Evidence was synthesized from retrospective cohorts, prospective clinical trials, and translational studies, highlighting how molecular heterogeneity, clonal evolution, and the tumor microenvironment complicate classification and treatment. While molecular subtypes such as MCD, BN2, EZB, A53, and ST2 have improved prognostication, their routine use in clinical practice remains limited due to cost, complexity, and restricted access to sequencing platforms. Tumor-informed ctDNA assays show promise for minimal residual disease (MRD) monitoring and adaptive therapy, yet their predictive power for CAR-T therapy, bispecific antibodies, and checkpoint inhibitors is still incompletely understood. Overall, the literature converges on the need for integrated strategies combining ctDNA, molecular subtyping, and immune microenvironment analysis to personalize frontline therapy. Full article

(This article belongs to the Collection Lymphomas)

43 pages, 2880 KB

Open AccessReview

Relevance of AKT and RAS Signaling Pathways for Antibody–Drug Conjugate Immunotherapies in Acute Lymphoblastic Leukemia

by Patrick A. H. Ehm and Christoph Rehbach

Lymphatics 2025, 3(4), 33; https://doi.org/10.3390/lymphatics3040033 - 13 Oct 2025

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Abstract

Acute lymphoblastic leukemia is the most common cause of cancer-related death in children and represents a poor prognosis for patients in high-risk groups. Current treatment protocols are based on intensive polychemotherapy, which is associated with a significant toxicity profile. Due to their higher [...] Read more.

Acute lymphoblastic leukemia is the most common cause of cancer-related death in children and represents a poor prognosis for patients in high-risk groups. Current treatment protocols are based on intensive polychemotherapy, which is associated with a significant toxicity profile. Due to their higher specificity and lower toxicity, immunotherapies based on monoclonal antibodies, in particular antibody–drug conjugates (ADCs), are revolutionizing cancer therapy. However, reports on the potential efficacy of ADC-targeted therapy in ALL and its subgroups are limited. Gene expression data suggest that potentially new ADC antigens are highly abundant in ALL subgroups and represent promising targets for cancer therapy. In addition, the PI3K/AKT and RAS/MAPK signaling pathways are often persistently activated in ALL and recent data showed that active feedback loops following inhibition of these pathways can lead to redundancy of cell surface receptors that can potentially serve as antigens for ADC treatment. Therefore, we provide here an overview of the most interesting receptors of the various ALL subgroups and discuss the influence that feedback loops of the PI3K/AKT and RAS/MAPK signaling pathways may have on increasing protein expression of the aforementioned receptors, which could lead to targeted combination therapy approaches in the future. Full article

(This article belongs to the Special Issue Advances in Lymphoid Disorders: Immunological Insights and Therapeutic Innovations)

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1 pages, 150 KB

Open AccessCorrection

Correction: Koizumi et al. Lipoperoxides as Prognostic Markers in Pediatric B-Acute Lymphocytic Leukemia Patients Undergoing Induction Chemotherapy. Lymphatics 2025, 3, 11

by Bruna Yukie Koizumi, Marina Rayciki Sotomayor, Carolina Coradi, Ana Luiza Goulart Starck, Anna Will Ribeiro, Maikely Bruna Leite, Maria Eduarda Pardal Simonato, Rafael Gomes Paz, Vinicius de Melo Tizzo, Stefania Tagliari Longo, Geise Ellen Broto, Fausto Celso Trigo and Carolina Panis

Lymphatics 2025, 3(4), 32; https://doi.org/10.3390/lymphatics3040032 - 13 Oct 2025

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Abstract

In the original publication [...] Full article

18 pages, 418 KB

Open AccessReview

Gastrointestinal Lymphomas: A Comprehensive Review of Epidemiology, Clinical Features, Diagnosis, Histopathology, and Management

by Vignesh Krishnan Nagesh, Ruchi Bhuju, Ahmed S. Mohammed, Emelyn Martinez, Marina Basta, Deepa Francis, Shraboni Dey, Maggie James, Damien Islek, Sanket Bhattarai, Mohammed A. Saafan, Shruthi Badam and Adam Atoot

Lymphatics 2025, 3(4), 31; https://doi.org/10.3390/lymphatics3040031 - 29 Sep 2025

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Abstract

Gastrointestinal (GI) lymphomas are a diverse group of extranodal non-Hodgkin lymphomas primarily affecting the stomach, small intestine, and colon. They present with non-specific symptoms such as abdominal pain, weight loss, or GI bleeding, making early diagnosis challenging. Histologic subtypes vary, with mucosa-associated lymphoid [...] Read more.

Gastrointestinal (GI) lymphomas are a diverse group of extranodal non-Hodgkin lymphomas primarily affecting the stomach, small intestine, and colon. They present with non-specific symptoms such as abdominal pain, weight loss, or GI bleeding, making early diagnosis challenging. Histologic subtypes vary, with mucosa-associated lymphoid tissue (MALT) lymphoma and diffuse large B-cell lymphoma (DLBCL) being the most common. Diagnosis involves endoscopic evaluation with biopsy, cross-sectional imaging, and often PET-CT. Management is subtype-dependent, including antibiotics for H. pylori-associated MALT lymphoma, chemotherapy, immunotherapy, and occasionally surgery. A multidisciplinary approach is essential for optimal outcomes. Core Tip: Gastrointestinal lymphomas are rare but clinically significant malignancies with variable presentations. Accurate diagnosis and tailored treatment based on the histologic subtype and site are critical, requiring close collaboration among gastroenterologists, pathologists, oncologists, and radiologists. Full article

(This article belongs to the Collection Lymphomas)

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10 pages, 3338 KB

Open AccessCase Report

Bronchiolitis Obliterans in a Young Female Patient with Paraneoplastic Pemphigus Associated with Unicentric Castleman’s Disease

by Walid Kteiche, Vasiliki Besa, Stefanie Werther, Dirk Theegarten, Stefanie Bertram, Enno Schmidt, Anna Daniels and Silke C. Hofmann

Lymphatics 2025, 3(4), 30; https://doi.org/10.3390/lymphatics3040030 - 24 Sep 2025

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Abstract

Background: Castleman’s disease (CD), also known as angiofollicular lymph node hyperplasia, describes a rare group of diseases manifesting with enlarged lymph nodes and various inflammatory symptoms. The association between Castleman’s disease, paraneoplastic pemphigus and bronchiolitis obliterans has been described in the literature and [...] Read more.

Background: Castleman’s disease (CD), also known as angiofollicular lymph node hyperplasia, describes a rare group of diseases manifesting with enlarged lymph nodes and various inflammatory symptoms. The association between Castleman’s disease, paraneoplastic pemphigus and bronchiolitis obliterans has been described in the literature and is depicted thoroughly in this case. Case Presentation: We present a case of severe bronchiolitis obliterans developing in a 17-year-old female with paraneoplastic pemphigus and unicentric Castleman’s disease. Conclusion: Surgical resection of unicentric Castleman’s disease remains the treatment of choice due to its efficacy in preventing the recurrence of associated morbidity caused by bronchiolitis obliterans and paraneoplastic pemphigus. Full article

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9 pages, 945 KB

Open AccessArticle

Transplanted Mesenteric Lymph Node Metastasis After Free Jejunal Reconstruction in Head and Neck Cancer

by Yuki Asahi, Tatsuhiko Yamada, Masashi Kuroki, Yuta Sato, Yoshihiro Tanaka, Manato Matsubara, Saki Akita, Rina Kato, Ryota Iinuma, Ryo Kawaura, Hiroshi Okuda, Kosuke Terazawa, Kenichi Mori, Hirofumi Shibata, Natsuko Ueda, Keishi Kohyama, Hisakazu Kato and Takenori Ogawa

Lymphatics 2025, 3(4), 29; https://doi.org/10.3390/lymphatics3040029 - 24 Sep 2025

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Abstract

Free jejunum is used for reconstruction after resection of advanced head and neck cancer. Postoperative transplanted mesenteric lymph nodes swelling is often experienced, but its clinical significance is unclear. This study included patients who underwent free jejunal reconstruction at Gifu University Hospital between [...] Read more.

Free jejunum is used for reconstruction after resection of advanced head and neck cancer. Postoperative transplanted mesenteric lymph nodes swelling is often experienced, but its clinical significance is unclear. This study included patients who underwent free jejunal reconstruction at Gifu University Hospital between March 2017 and November 2023. Regarding the size change of postoperative mesenteric lymph node and risk factors, the correlation with metastasis and prognosis was investigated. This study included 51 patients, of whom 16 cases (31.4%) had postoperative mesenteric lymph node swelling and 2 cases (3.9%) had metastasis. Only two cases with metastasis showed an increase in size of 5 mm or more. Many cases without extracapsular extension and cases of salvage surgery had postoperative mesenteric lymph node swelling (p = 0.0429, p = 0.0269). No correlation was found between postoperative mesenteric lymph node swelling and prognosis. However, because all cases with metastasis were included in cases of postoperative mesenteric lymph node swelling, this could be one factor in determining whether or not metastasis occurred. The transplanted mesenteric lymph node swelling is one of the important postoperative evaluation items, and additional evaluation such as PET-CT may be recommended. Full article

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Lymphatics, Volume 3, Issue 4 (December 2025) – 7 articles

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