Intussusceptive angiogenesis and its counterpart intussusceptive lymphangiogenesis
L. Díaz-Flores1, R. Gutiérrez1, S. Gayoso1, M.P. García2, M. González-Gómez1, L. Díaz-Flores Jr1, R. Sánchez3, J.L. Carrasco1 and J.F. Madrid4
1Department of Basic Medical Sciences, Faculty of Medicine, University of La Laguna, 2Department of Pathology, Eurofins® Megalab-Hospiten Hospitals, 3Department of Internal Medicine, Dermatology and Psychiatry, Faculty of Medicine, University of La Laguna, Tenerife and 4Department of Cell Biology and Histology, School of Medicine, Campus of International Excellence "Campus Mare Nostrum", IMIB-Arrixaca, University of Murcia, Murcia, Spain
Offprint requests to: Lucio Díaz-Flores, Universidad de La Laguna, Facultad de Medicina, Departamento de Ciencias Médicas Básicas, Ofra-La Cuesta s/n, La Laguna, 38071 Tenerife, Islas Canarias, Spain. email: kayto54@gmail.com
Summary. Intussusceptive angiogenesis (IA) is currently considered an important alternative and complementary form of sprouting angiogenesis (SA). Conversely, intussusceptive lymphangiogenesis (IL) is in an initial phase of study. We compare their morphofunctional characteristics, since many can be shared by both processes. To that end, the following aspects are considered: A) The concept of IA and IL as the mechanism by which blood and lymphatic vessels split, expand and remodel through transluminal pillar formations (hallmarks of intussusception). B) Terminology and historical background, with particular reference to the group of Burri, including Djonov and Patan, who initiated and developed the vessel intussusceptive concept in blood vessels. C) Incidence in normal (e.g. in the sinuses of developing lymph nodes) and pathologic conditions, above all in vessel diseases, such as dilated veins in hemorrhoidal disease, intravascular papillary endothelial hyperplasia (IPEH), sinusoidal hemangioma, lobular capillary hemangioma, lymphangiomas/lymphatic malformations and vascular transformation of lymph nodes. D) Differences and complementarity between vessel sprouting and intussusception. E) Characteristics of the cover (endothelial cells) and core (connective tissue components) of pillars and requirements for pillar identification. F) Structures involved in pillar formation, including endothelial contacts of opposite vessel walls, interendothelial bridges, merged adjacent capillaries, vessel loops and spilt pillars. G) Structures resulting from pillars with intussusceptive microvascular growth, arborization, remodeling and segmentation (compartmentalization). H) Influence of intussusception in the morphogenesis of vessel tumors/ pseudotumors; and I) Hemodynamic and molecular control of vessel intussusception, including VEGF, PDGF BB, Hypoxia, Notch, Endoglobin and Nitric oxide. Histol Histopathol 35, 1083-1103 (2020)
Key words: Lymphangiogenesis, Intussusceptive angiogenesis
DOI: 10.14670/HH-18-222