marginal sinus
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2021 ◽  
Author(s):  
Visish M Srinivasan ◽  
Joshua S Catapano ◽  
Fabio A Frisoli ◽  
Michael A Mooney ◽  
Michael T Lawton

Abstract Dural arteriovenous fistulas (DAVFs) are benign but may present with life-threatening hemorrhage or symptoms of venous hypertension (eg, progressive myelopathy).1-3 DAVFs follow well-described anatomic patterns.4 The marginal sinus is located between the layers of the dura, circumferentially around the foramen magnum. It communicates with the basal venous plexus of the clivus anteriorly and the occipital sinus posteriorly.5,6 Arterial supply to the dura in this region that fistulizes into the sinus arises from meningeal branches from the V3 or V4 segments.  A man in his early 70s presented with chronic neck pain and new onset of left arm and face paresthesias. He had brisk patellar reflexes bilaterally and a marginal sinus DAVF, with numerous dilated veins around the cisterna magna, causing dorsal cervicomedullary compression. Angiography confirmed the diagnosis of DAVF rather than arteriovenous malformation. Endovascular embolization was considered, but surgery was preferable because of poor transarterial access.  The patient underwent left far lateral craniotomy and C1 laminectomy with exposure of the condylar fossa. The dura was carefully elevated laterally, revealing a network of dilated tortuous veins, with multiple points of fistulous connection within the dura emanating in a large venous varix. Indocyanine green videoangiography showed the aberrant flow dynamics. The fistulous point was occluded with aneurysm clips on the venous side, then cauterized and interrupted. The patient was discharged within 3 d of surgery and had full resolution of symptoms at 6 wk. Angiography confirmed complete obliteration of the DAVF. The patient provided written informed consent for treatment. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.


Cell Reports ◽  
2021 ◽  
Vol 36 (2) ◽  
pp. 109346
Author(s):  
Kathrin Werth ◽  
Elin Hub ◽  
Julia Christine Gutjahr ◽  
Berislav Bosjnak ◽  
Xiang Zheng ◽  
...  

Medicine ◽  
2021 ◽  
Vol 100 (1) ◽  
pp. e24253
Author(s):  
Hiroki Ishibashi ◽  
Morikazu Miyamoto ◽  
Hiroshi Shinmoto ◽  
Shigeyoshi Soga ◽  
Hideki Iwahashi ◽  
...  

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 38-39
Author(s):  
Daniela Gómez Atria ◽  
Brian T. Gaudette ◽  
Eric Perkey ◽  
Jennifer Londregan ◽  
Samantha Kelly ◽  
...  

In lymphopenic environments, secondary lymphoid organs regulate the size of B and T cell compartments by supporting homeostatic proliferation of mature lymphocytes. Although this process operates in multiple clinically relevant settings, including after bone marrow transplantation and chemotherapy as well as in aging individuals, little is known about its underlying molecular mechanisms and functional consequences. In mice, mature naïve B cells include mostly follicular B (FoB) cells in spleen and lymph nodes, as well as specialized marginal zone B (MZB) cells in the spleen with innate-like functions and a capacity for rapid plasma cell differentiation. To identify mechanisms controlling the size and composition of the peripheral B cell pool, we developed a mouse model in which highly purified CTV-labelled B6-CD45.1 FoB cells were adoptively transferred intravenously to lymphopenic B6-CD45.2 Rag2-/- mice, lacking mature B and T cells, or control B6-CD45.2 lymphoid-replete recipients. Within two days after transfer of CD19+ CD93neg CD21int CD23high B6-CD45.1 FoB cells (106, >99% purity), CD45.1+ donor-derived B cells had upregulated expression of surface IgM (sIgM) and CD21 in the spleen of Rag2-/- recipients, but not in wild type control recipients. At day 4 and day 8, the majority of transferred B cells remained sIgMhi and CD21hi in Rag2-/- recipients and gradually showed decreased CD23 and sIgD as well as increased CD1d expression, consistent with loss of their FoB phenotype and acquisition of a characteristic MZB cell phenotype (sIgMhisIgDlow CD21hi CD1dhi CD23low). These phenotypic changes were followed by a burst of proliferation (CTV dilution) between day 4 and day 8 after transfer. Immunofluorescence microscopy of host Rag2-/- spleen sections at day 2 post-transfer identified clusters of transferred B cells localized around CD169+ macrophages at the white pulp/red pulp interface close to the marginal sinus, with subsequent proliferation in this area. We next investigated if Notch signaling regulates this transdifferentiation process, by analogy to its role in normal MZB cell homeostasis. Treatment of Rag2-/- recipients with blocking antibodies against Delta-like-1 Notch ligands (anti-DLL1) or Notch2 receptors (anti-NRR2) completely inhibited lymphopenia-induced FoB to MZB cell conversion and proliferation. To identify the cellular source of DLL1 Notch ligands, we studied transferred B cells in Rag2-/-;Ccl19-Cre+;Dll1f/f recipients, lacking Dll1 expression in all Ccl19-Cre+ fibroblastic reticular cells and their progeny. In these mice as compared to Rag2-/- recipients, FoB to MZB transdifferentiation was almost completely abrogated and transferred cells no longer clustered with marginal sinus-associated macrophages. Thus, stromal DLL1 Notch ligands are critical to regulate the size and composition of the splenic peripheral B cell pool in lymphopenic mice through DLL1/Notch2 interactions. Furthermore, FoB cells are not locked in their FoB cell fate, as commonly assumed, but are instead endowed with plastic transdifferentiation potential in response to DLL1/Notch2-mediated signals that function as a sensor of B cell lymphopenia. We speculate that these adaptive physiological functions of the Notch signaling pathway play an important role in the homeostasis of mature B cells within their stromal microenvironment, and that they can be hijacked during malignant transfomation in Notch-dependent mature B cell lymphomas such as CLL and marginal zone lymphoma. Disclosures Siebel: Genentech: Current Employment. Maillard:Allogene: Consultancy; Regeneron: Consultancy; Genentech: Consultancy.


2020 ◽  
Author(s):  
Craig Hacking ◽  
Frank Gaillard

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Shigeki Kato ◽  
Yuko Shirai ◽  
Maya Sakamoto ◽  
Shiro Mori ◽  
Tetsuya Kodama

Abstract Lymph node (LN) metastasis through the lymphatic network is a major route for cancer dissemination. Tumor cells reach the marginal sinuses of LNs via afferent lymphatic vessels (LVs) and form metastatic lesions that lead to distant metastasis. Thus, targeting of metastatic cells in the marginal sinuses could improve cancer treatment outcomes. Here, we investigated whether lymphatic administration of a drug combined with sonoporation could be used to treat a LN containing proliferating murine FM3A breast cancer cells, which are highly invasive, in its marginal sinus. First, we used contrast-enhanced high-frequency ultrasound and histopathology to analyze the structure of LVs in MXH10/Mo-lpr/lpr mice, which exhibit systemic lymphadenopathy. We found that contrast agent injected into the subiliac LN flowed into the marginal sinus of the proper axillary LN (PALN) and reached the cortex. Next, we examined the anti-tumor effects of our proposed technique. We found that a strong anti-tumor effect was achieved by lymphatic administration of doxorubicin and sonoporation. Furthermore, our proposed method prevented tumor cells in the marginal sinus from invading the parenchyma of the PALN and resulted in tumor necrosis. We conclude that lymphatic administration of a drug combined with sonoporation could exert a curative effect in LNs containing metastatic cells in their marginal sinuses.


2019 ◽  
Vol 10 (02) ◽  
pp. 334-338
Author(s):  
Thomas J. Buell ◽  
Daniel M. S. Raper ◽  
Dale Ding ◽  
Ching-Jen Chen ◽  
Tony R. Wang ◽  
...  

ABSTRACTNonthrombotic intracranial venous occlusive disease (NIVOD) has been implicated in the pathophysiology of idiopathic intracranial hypertension (IIH) and various non-IIH headache syndromes. Endovascular stenting of stenotic, dominant transverse sinuses (TSs) may reduce trans-stenosis pressure gradients, decrease intracranial pressure, and alleviate symptoms in a subset of NIVOD patients. We present a case in which concurrent stenting of the occipito-marginal sinus obliterated the residual trans-stenosis pressure gradient across an initially stented dominant TS. We hypothesize that this observation may be explained using an electric-hydraulic analogy, and that this patient’s dominant TS and occipito-marginal sinus may be modeled as a parallel hemodynamic circuit. Neurointerventionalists should be aware of parallel hemodynamic drainage patterns and consider manometry and possibly additional stenting of stenotic, parallel venous outflow pathways if TS stenting alone fails to obliterate the trans-stenosis pressure gradient.


2019 ◽  
Vol 7 (4) ◽  
pp. 826-828
Author(s):  
Eiji Ryo ◽  
Shigenari Namai ◽  
Ippei Nakagawa ◽  
Ranka Kanda ◽  
Keita Yatsuki ◽  
...  
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