Cytoarchitecture of the Lamina Muscularis Mucosae and Distribution of the Lymphatic Vessels in the Human Stomach

The aim of the present study was to clarify the anatomical structure of the lamina muscularis mucosae (LMM) in the human stomach and to correlate it with the lymphatic spread of gastric cancer cells. Human stomachs taken at operation or autopsy were used. The specimens derived from these stomachs were examined by light microscopy immunohistochemistry and scanning electron microscopy (SEM). In the cardia and pyloric wall, bundles of smooth muscle cells of the LMM were relatively loose and thin and formed a reticular configuration. Small lymphatic capillaries (approximately 10-30 μm in diameter) were present directly above the LMM, and relatively large lymphatics (approximately 80-100 μm in diameter) were observed in the submucosal layer and within the LMM. In contrast, the LMM in the fundus, body, and antral wall was composed of tight, thick bundles of smooth muscle cells that ran straight. Large lymphatics were found directly beneath the LMM, but they were few in the lamina propria mucosae. In addition, lymphatics adjacent to veins were also found in the submucosa of the fundus. Structural differences in the LMM of the stomach wall might depend on physiological function. In this study, the relationship between the cytoarchitecture of the LMM or the distribution of lymphatic vessels and cancer invasion is discussed.