Sphincter of the lymphovenous junction: structural and functional features

Objective: to investigate the sphincter of the lymphovenous junction under normal conditions.

Material and methods: twenty post-mortem tissue samples were analyzed. The samples were divided into 2 groups: the study group 40-59 years old (n=10, 5 male/5 female) and the comparison group 60-80 years old (n=10, 5 male/5 female). Methods included dissection of the terminal segment of the thoracic duct, sonolipodestruction using the LySonix 3000® system for tissue clearing, light microscopy, Masson’s trichrome staining, and computer angiolymphography.

Results: a circumferential arrangement of muscle fibers forming a sphincter in the region of the terminal thoracic duct segment was identifie. Three fiber types were distinguished morphologically: (1) encircling fibers tightly surrounding the duct, (2) globular fibers, and (3) longitudinal fibers oriented along the duct. Morphometric parameters of the sphincter were obtained. Angiolymphography demonstrated accumulation of contrast in the terminal thoracic duct segment proximal to the sphincter. Conclusion: the morphology of the sphincter of the lymphovenous junction is described. Muscle fibers and valves of the terminal thoracic duct segment form a sphincter apparatus.

1. Davis M.J., Zawieja S.D., King P.D. Transport and Immune Functions of the Lymphatic System. Annu Rev Physiol. 2025;87(1):151–172. DOI: 10.1146/annurev-physiol-022724-104908.

2. O’Hagan L.A., et al. Anatomy of lymphovenous valve structures in the thoracic duct at the jugulo-subclavian junction. J Anat. 2020. DOI: 10.1111/joa.13167.

3. Petrenko V.M. Structural basis of active lymph transport. International Journal of Applied and Fundamental Research. 2010;(2):29–31.

4. Borisov A.V. Principles of the design of the lymphatic vessel in the light of the lymphangion theory. Structural and functional bases of the lymphatic system (theoretical and applied aspects). 1997;(1):6–12. (In Russ.).

5. El Zawahry M.D., et al. Study of the gross anatomy of the terminal part of the thoracic duct. Int Surg. 1983;68:135–138.

6. Langford R.J. Valves in the subsidiary lymph trunks of the human head and neck. J Craniomaxillofac Surg. 2002;30(2):121–124. DOI: 10.1054/jcms.2002.0298.

7. Method of evisceration of the terminal thoracic duct section on cadavers. Patent RU 2024114115. Gantsev Sh.Kh., Rizvanov A.A., Kzyrgalin Sh.R., Shchekin S.V., Tursumetov D.S., Mansurova A.V., Gantsev K.Sh., Faizalizoda S. Date of registration: 24.05.2024. (In Russ.).

8. Breslin J.W., et al. Lymphatic vessel network structure and physiology. Compr Physiol. 2019;9:207–299.

9. Haider M., et al. Thoracic duct lymph and PEEP studies in critically ill patients. Intensive Care Med. 1987;13:183. DOI: 10.1007/BF00254702.

10. Gantsev Sh.Kh., Arybzhanov D.T., Kzyrgalin Sh.R., Gantsev K.Sh., Mansurova A.V., Mirzoev M.Sh. Functional and anatomical features of the lymphovenous junction. Bulletin of Avicenna. 2022;24(3):369–378. (In Russ.).

11. Shah P., Louis M.A. Physiology, Central Venous Pressure. Stat Pearls. 2023.

12. Kinnaert P. Measurement of pressure in the thoracic duct in man. Br J Surg. 1973;60:558–561. DOI: 10.1002/bjs.1800600717.

13. Olmeda D., Cerezo-Wallis D., Castellano-Sanz E., García-Silva S., Peinado H., Soengas M.S. Physiological models for in vivo imaging and targeting the lymphatic system: Nanoparticles and extracellular vesicles. Adv Drug Deliv Rev. 2021;175:113833. DOI: 10.1016/j.addr.2021.113833.

14. Bautch V.L., Caron K.M. Blood and lymphatic vessel formation. Cold Spring Harb Perspect Biol. 2015;7(3):a008268. DOI: 10.1101.

15. Shimada K., Sato I. Morphological and histological analysis of lymphatic vessels in the human dura mater. Clin Anat. 1997;10:163–172.