Background:
The diaphragm has a unique system that collects peritoneal fluid and carries it into the lymphatic system. however, our understanding of the morphology and function of this system is still incomplete.
Methods:
Twelve c57bl/6 mice of 13 to 25 weeks of age were used without regard to sex. in one series of experiments, the diaphragm was isolated and fixed 10-15 minutes after injection of india ink into the peritoneal cavity and then the peritoneal mesothelium was peeled off from the submesothelial connective tissue. the lymphatic vessels attached to the mesothelial strip were examined by scanning electron microscopy. the diaphragm was also observed in plastic-embedded semithin and ultrathin sections. in another series of experiments, the diaphragm was stained by 5'-nucleotidase histochemistry (wachstein and meizel, 1957a. am. j. clin. pathol., 27:13-23), and several microdrops of india ink were placed on the peritoneal or pleural surface to reveal the profile of the lymphatic vessels.
Results:
The lymphatic vessels on the peritoneal side of the diaphragm were flattened. they usually ranged from several to 100 microns in width and from close to zero to a few micrometers in thickness. in other words, they formed extremely flat lumina, differing from the more usual tubular lymphatic vessels. several lymphatic vessels extended radially and parallel to one another from the central tendon to the thoracic wall, with numerous connecting branches, forming an area of lymphatic vessels. the india ink that had been injected intraperitoneally and the staining with 5'-nucleotidase revealed that there were seven to nine such lymphatic areas in one hemisphere of the diaphragm. the lymphatic areas spread in parallel with the peritoneal surface of the diaphragm and all the areas together appeared to occupy more than half the surface area of the sternocostal part of the diaphragm. each area was a relatively distinct functional unit with respect to the draining of india ink. microdrops of india ink placed on the pleural surface did not enter the lymphatic vessels, while those placed on the peritoneal surface immediately entered the peritoneal lymphatic vessels and migrated to the pleural lymphatic vessels via the transmuscular lymphatic branches.
Conclusions:
The peritoneal lymphatic vessels of the diaphragm have extremely flat lumina that spread in parallel with the peritoneal surface of the diaphragm and form a lymphatic sieve that covers approximately half or more of the surface area of the sternocostal region for drainage of fluid and particulate matter from the peritoneal cavity. the lymphatic system has been characterized by the presence of openings (= stomata) to the peritoneal cavity and the amplitude of the lumina (= lacunae). however, the fundamental characteristic of the system is the extremely flat lumen (= vadum), which facilitates the formation of the lymphatic sieve.