Three-dimensional and ultrastructural aspects of the lymphatic vascularization of the vermiform appendix.

The aim of the study is to reveal the three-dimensional distribution and ultrastructure of the peripheral absorbing lymphatic vessels of the vermiform appendix, since the gut-associated lymphoid tissue is necessary to the immune responses to the enteric antigens. Corrosion casts showed the beginning of the lymphatic vascularization at the tunica mucosa, which lacks intestinal villi, through a tight, delicate lymphatic network. This network drains the lymph by peculiar straight vessels, distributed in the mucosal beams that separate the adjacent follicle domes, in the fine network of the upper portion of the lymphatic basket, surrounding the lateral walls of the basal and medium portions of each lymphoid follicle. This network, which is made of large caliber vessels that are not dilated like sinuses, continues through small vessels into the large dome-like vessels of the submucosa, which in turn by way of the lymphatic vessels of the muscular tunica, drain into the subserous precollector valved lymphatic vessels that flow into the pre-lymph node collectors. We underlined that the particular fluidity of Neoprene latex and the direct injection method, when compared with other substances and injection methods, provided us with exceptionally clear and precise three-dimensional plastic images of the absorbing lymphatic vessels. Moreover, these images extraordinarily illustrated the preservation of the absorbing lymphatic spatial relationships with blood vessels. Ultrastructural features and three-dimensional models of ultrathin serial sections of the absorbing peripheral lymphatic vessels showed a continuous endothelial wall lacking basal lamina, as well as open junctions between adjacent cells. Moreover, we observed the presence of numerous lymphocytes, together with intense transendothelial migratory activity that occurs through intraendothelial channel formations, dynamic entities, at absorbing lymphatic vessels of the peri-interfollicular lymphoid tissue. Also, we saw that the germinal center, as well as the lymphoid follicle dome, lacked lymphatic absorbing vessels. In addition, many postcapillary high endothelial venules (HEV) were observed with lymphocyte migration into the extravasal compartment. Furthermore, we maintain that the absorbing peripheral lymphatic vessels (ALPA) of the tunica mucosa play an important role in liquid drainage. For the peri-interfollicular vessels, we hypothesize a potential migratory and a reserve capacity for lymphocytes, as well as a conduction activity for the muscular tunica and submucosa vessels.