These results suggest a causal relationship between lipotoxicity and lymphatic proliferation with a cellular link to macrophage activation, such that pro-inflammatory M1 type macrophages in DN contributed to the development of intrarenal lymphangiogenesis through stimulation of VEGF-C and by its transdifferentiation into LECs that integrate into the sprouting lymphatics. The gene discussed is VEGFC; the disease is liver dysplastic nodule.