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Lymphatic malformations: mechanistic insights and evolving therapeutic frontiers
Milena Petkova, … , Ingvar Ferby, Taija Mäkinen
Milena Petkova, … , Ingvar Ferby, Taija Mäkinen
Published March 15, 2024
Citation Information: J Clin Invest. 2024;134(6):e172844. https://doi.org/10.1172/JCI172844.
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Review Series

Lymphatic malformations: mechanistic insights and evolving therapeutic frontiers

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Abstract

The lymphatic vascular system is gaining recognition for its multifaceted role and broad pathological significance. Once perceived as a mere conduit for interstitial fluid and immune cell transport, recent research has unveiled its active involvement in critical physiological processes and common diseases, including inflammation, autoimmune diseases, and atherosclerosis. Consequently, abnormal development or functionality of lymphatic vessels can result in serious health complications. Here, we discuss lymphatic malformations (LMs), which are localized lesions that manifest as fluid-filled cysts or extensive infiltrative lymphatic vessel overgrowth, often associated with debilitating, even life-threatening, consequences. Genetic causes of LMs have been uncovered, and several promising drug-based therapies are currently under investigation and will be discussed.

Authors

Milena Petkova, Ingvar Ferby, Taija Mäkinen

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Figure 1

Features of genetic lymphatic anomalies associated with lymphatic vessel overgrowth.

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Features of genetic lymphatic anomalies associated with lymphatic vessel...
Schematic representation of the main clinical features of lymphatic anomalies characterized by lymphatic overgrowth (indicated in blue): cystic LMs, complex lymphatic anomalies (CLAs), and LMs associated with segmental overgrowth syndromes (PROS). The following definitions are based on the classification for vascular anomalies proposed by the International Society for the Study of Vascular Anomalies (ISSVA): LM, lymphatic malformation; GLA, generalized lymphatic anomaly; KLA, Kaposiform lymphangiomatosis; GSD, Gorham-Stout disease; CCLA, central conducting lymphatic anomaly; PROS, PIK3CA-related overgrowth spectrum; KTS, Klippel-Trenaunay syndrome; CLOVES, congenital lipomatous overgrowth, vascular malformations, epidermal nevi, and scoliosis/skeletal/spinal anomalies. KLA and GSD are characterized by bone lesions (as indicated with asterisks), and CCLA is associated with dilation of and leakage from central lymphatic vessels.

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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