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Lymphatic Vessels in the Human Endometrium: Are they Present or Absent?

Tatsuo Tomita and Kuni Mah

The presence and structure-function relationship of lymphatic vessels in the human endometrium are still sketchy and unsettled: some authors claimed that there were no lymphatic vessels [1,2] but more reports agreed that lymphatic vessels are present in the human endometrium, especially in the basalis but may not be in the functionalis [3-6]. Recently more reliable Immunocytochemical markers for lymphatic vessels became available and have been widely utilized using D2-40 [7] and lymphatic epithelial hyaluronan receptor-1 (LYVE-1) [8]. D2-40 recognizes the collecting lymphatic vessels and LYVE-1 recognizes mainly lymphatic capillaries [9]. With routinely formalin-fixed and paraffin-embedded sections, not all lymphatic sections are immunostained but frozen sections provide consistently much more lymphatic and venous vessels. There are numerous lymphatic vessels in the myometrium and basalis in all menstrual phases. In the Day 3 endometrium from the menstrual period, there were numerous small lymphatic vessels in the remaining basalis by both D2-40 and LYVE-1. There are cyclic changes of lymphatic vessels in the functionalis: The early proliferative phase endometrium, Day 5 showed very few, small lymphatic vessels in the lower functionalis (Figure 1) and Day 9 endometrium revealed few lymphatic vessels in the upper endometrium.