Chen, J.-F.; Chang, Q.; Shu, Y.; Liu, H.; Ko, P.-F.

The anatomical localization of lymphatic vessels in bone remains controversial and has led to conflicting interpretations of skeletal lymphatic function. Here we assessed lymphatic identity and localization in bone using mouse genetic labeling, tissue clearance, and three-dimensional imaging. We analyzed long bones after extensive periosteum removal and identified Vegfr3 blood vessels lacking Lyve1 expression within bone marrow, whereas Vegfr3Lyve1 lymphatic vessels were confined to residual periosteal regions. Genetic lineage tracing using Prox1-Cre/ER;mScarlet further confirmed that lymphatic vessels are absent from long bone marrow and restricted to periosteal compartments, particularly in fibrous but not cambial layers. Extending these analyses to the mandible, we observed Vegfr3Lyve1 lymphatic vessels localized to periarticular soft tissues surrounding the temporomandibular joint (TMJ), while mandibular bone marrow contained only Vegfr3Lyve1- blood vessels and lacked Prox1 lineage-traced lymphatic vessels. Together, these findings establish that lymphatic vessels in bone are confined to periosteal and periarticular compartments and absent from bone marrow, providing a framework for interpreting lymphatic contributions to skeletal physiology and disease.