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Bakker AC, Fishman SJ, Liang MG, Al-Ibraheemi A, Kozakewich HP, Mulliken JB, Slack JC. Immunohistochemical Expression of Lymphatic Endothelial Markers in Blue Rubber Bleb Nevus Syndrome. Pediatr Dev Pathol 2024; 27:228-234. [PMID: 38512910 DOI: 10.1177/10935266241228930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
INTRODUCTION Blue rubber bleb nevus syndrome (BRBNS) is an uncommon vascular anomaly characterized by multifocal cutaneous, visceral, and other soft tissue or solid organ venous malformations. We observed that BRBNS lesions express immunohistochemical markers of lymphatic differentiation. METHODS BRBNS histopathologic specimens assessed at our institution during the past 27 years were reviewed. Slides from 19 BRBNS lesions were selected from 14 patients (9 cutaneous, 9 gastrointestinal, and 1 hepatic). We recorded the involved anatomical compartments and presence/absence of thrombi or vascular smooth muscle. Immunohistochemical endothelial expression of PROX1 (nuclear) and D2-40 (membranous/cytoplasmic) was evaluated semi-quantitatively. RESULTS Endothelial PROX1 immunopositivity was noted in all specimens; the majority (89.5%) demonstrated staining in more than 10% of cells. D2-40 immunopositivity was present in one-third (33%) of cutaneous lesions and only 1 gastrointestinal lesion. CONCLUSION Endothelial cells in BRBNS almost always express 1 or more immunohistochemical markers of lymphatic differentiation.
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MESH Headings
- Humans
- Nevus, Blue/metabolism
- Nevus, Blue/pathology
- Nevus, Blue/diagnosis
- Skin Neoplasms/pathology
- Skin Neoplasms/metabolism
- Skin Neoplasms/diagnosis
- Male
- Child
- Female
- Immunohistochemistry
- Child, Preschool
- Adolescent
- Gastrointestinal Neoplasms/metabolism
- Gastrointestinal Neoplasms/pathology
- Gastrointestinal Neoplasms/diagnosis
- Biomarkers, Tumor/metabolism
- Biomarkers, Tumor/analysis
- Infant
- Tumor Suppressor Proteins/metabolism
- Tumor Suppressor Proteins/analysis
- Homeodomain Proteins/metabolism
- Endothelium, Lymphatic/metabolism
- Endothelium, Lymphatic/pathology
- Antibodies, Monoclonal, Murine-Derived/metabolism
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Affiliation(s)
- Andrea C Bakker
- Departments of Pathology, Boston Children's Hospital, Boston, MA, USA
| | - Steven J Fishman
- Department of Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Marilyn G Liang
- Department of Dermatology, Boston Children's Hospital, Boston, MA, USA
| | | | | | - John B Mulliken
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Jonathan C Slack
- Departments of Pathology, Boston Children's Hospital, Boston, MA, USA
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2
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Wu Z, Lin Q, Song H, Chen J, Wang G, Fu G, Cui C, Su X, Li L, Bian T. Evaluation of Lymphatic Vessel Invasion Determined by D2-40 Using Preoperative MRI-Based Radiomics for Invasive Breast Cancer. Acad Radiol 2023; 30:2458-2468. [PMID: 36586760 DOI: 10.1016/j.acra.2022.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 12/30/2022]
Abstract
RATIONALE AND OBJECTIVES Preoperative prediction of LVI status can facilitate personalized therapeutic planning. This study aims to investigate the efficacy of preoperative MRI-based radiomics for predicting lymphatic vessel invasion (LVI) determined by D2-40 in patients with invasive breast cancer. MATERIALS AND METHODS A total of 203 patients with pathologically confirmed invasive breast cancer, who underwent preoperative breast MRI, were retrospectively enrolled and randomly assigned to the following cohorts: training cohort (n=141) and test cohort (n=62). Then, univariate and multivariate logistic regression were performed to select independent risk factors and build a clinical model. Afterwards, least absolute shrinkage and selection operator (LASSO) logistic regression was performed to select predictive features extracted from the early and delay enhancement dynamic contrast-enhanced (DCE)-MRI images, and a radiomics signature was established. Subsequently, a nomogram model was constructed by incorporating the radiomics score and risk factors. Receiver operating characteristic curves were performed to determine the performance of various models. The efficacy of the various models was evaluated using calibration and decision curves. RESULTS Fourteen radiomics features were selected to construct the radiomics model. The size of the lymph node was identified as an independent risk factor of the clinical model. The nomogram model demonstrated the best calibration and discrimination performance in both the training and test cohorts, with an area under the curve of 0.873 (95% confidence interval [CI]: 0.807-0.923) and 0.902 (95% CI: 0.800-0.963), respectively. The decision curve illustrated that the nomogram model added more net benefits, when compared to the radiomics signature and clinical model. CONCLUSION The nomogram model based on preoperative DCE-MRI images exhibits satisfactory efficacy for the noninvasive prediction of LVI determined by D2-40 in invasive breast cancer.
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Affiliation(s)
- Zengjie Wu
- Department of Radiology, the Affiliated Hospital of Qingdao University, Shandong, China
| | - Qing Lin
- Breast Disease Center, the Affiliated Hospital of Qingdao University, No. 59 Haier Road, Qingdao 266000, Shandong, China
| | - Hongming Song
- Breast Disease Center, the Affiliated Hospital of Qingdao University, No. 59 Haier Road, Qingdao 266000, Shandong, China
| | - Jingjing Chen
- Breast Disease Center, the Affiliated Hospital of Qingdao University, No. 59 Haier Road, Qingdao 266000, Shandong, China
| | - Guanqun Wang
- Department of Pathology, the Affiliated Hospital of Qingdao University, Shandong, China
| | - Guangming Fu
- Department of Pathology, the Affiliated Hospital of Qingdao University, Shandong, China
| | - Chunxiao Cui
- Breast Disease Center, the Affiliated Hospital of Qingdao University, No. 59 Haier Road, Qingdao 266000, Shandong, China
| | - Xiaohui Su
- Breast Disease Center, the Affiliated Hospital of Qingdao University, No. 59 Haier Road, Qingdao 266000, Shandong, China
| | - Lili Li
- Breast Disease Center, the Affiliated Hospital of Qingdao University, No. 59 Haier Road, Qingdao 266000, Shandong, China
| | - Tiantian Bian
- Breast Disease Center, the Affiliated Hospital of Qingdao University, No. 59 Haier Road, Qingdao 266000, Shandong, China..
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Sharma A, Natarajan S, Manaktala N, Boaz K, KP N, Lewis A, Yellapurkar S. Prognostic Nomogram for Lymph-Node Metastasis in Oral Squamous Cell Carcinoma (OSCC) Using Immunohistochemical Marker D2-40. Cancer Manag Res 2023; 15:929-936. [PMID: 37674659 PMCID: PMC10478775 DOI: 10.2147/cmar.s408772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 07/24/2023] [Indexed: 09/08/2023] Open
Abstract
Introduction Nomograms are proven in "individualized risk prediction" in sarcomas and breast and prostate cancers. Incorporating immunohistochemical markers and histopathological parameters can enhance accuracy of these graphical representations of statistical predictive models concerning metastasis. D2-40, a monoclonal antibody to podoplanin (regulator of motility expressed in malignant epithelial cells), dually predicts metastatic potential of tumour by estimating the motile tumour phenotype and by detecting lymphatic vessels/density, both essential to metastasis in OSCC. Thus, we propose a model that incorporates D2-40 immunostaining of individual tumour cells (ITC) too with other variables (seen in H+E staining) as a predictive nomogram. Methods Sixty cases of OSCC were selected with equal number of cases (n=30) of pN0 and pN+ status. Bryne's grading of invasive front of tumour (ITF) was done on H+E-stained slides followed by D2-40 immunostaining for ITCs at ITF and lymphatic vessels. Multivariate regression analysis was used to generate the nomogram of LNM where the predictive contribution of each covariate, namely depth of invasion, D2-40-stained ITCs, gender, histological grade, and worst pattern of invasion (WPOI), was plotted on a scale of 1-100 points. Results The nomogram showed that the strongest variable in OSCC was the WPOI in H+E-stained section followed by D2-40-positive ITCs and gender. Discussion Our predictive nomogram for LNM in OSCC surprisingly showed that a tumour with lower score of WPOI (islands vs ITC) showed numerous D2-40-positive ITCs, drastically increasing the probability of metastasis. The concept of "individualized risk prediction" can be used to predict lymph node metastasis using a variety of histopathological criteria that can be visualized in routine and immunohistochemical staining in OSCC with the aid of a nomogram.
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Affiliation(s)
- Ankita Sharma
- Department of Oral Pathology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Srikant Natarajan
- Department of Oral Pathology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Nidhi Manaktala
- Department of Oral Pathology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Karen Boaz
- Department of Oral Pathology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Nandita KP
- Department of Oral Pathology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Amitha Lewis
- Department of Oral Pathology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shweta Yellapurkar
- Department of Oral Pathology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Silva EV, de Andrade BAB, Silveira HA, Rocha EM, Chahud F, Brunaldi MO, Bufalino A, León JE. Characterization of ectopic germinal centers in Sjögren's syndrome (SS) and non-SS non-sicca patients. Oral Dis 2023. [PMID: 37565506 DOI: 10.1111/odi.14711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/28/2023] [Accepted: 07/31/2023] [Indexed: 08/12/2023]
Affiliation(s)
- Evânio Vilela Silva
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara Dental School, Sao Paulo State University (UNESP), São Paulo, Brazil
- Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, Brazil
| | - Bruno Augusto Benevenuto de Andrade
- Oral Pathology, Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Heitor Albergoni Silveira
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara Dental School, Sao Paulo State University (UNESP), São Paulo, Brazil
- Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, Brazil
| | - Eduardo Melani Rocha
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School (FMRP/USP), University of São Paulo, Ribeirão Preto, Brazil
| | - Fernando Chahud
- Department of Pathology and Forensic Medicine, Ribeirão Preto Medical School (FMRP/USP), University of São Paulo, Ribeirão Preto, Brazil
| | - Mariângela Ottoboni Brunaldi
- Department of Pathology and Forensic Medicine, Ribeirão Preto Medical School (FMRP/USP), University of São Paulo, Ribeirão Preto, Brazil
| | - Andreia Bufalino
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara Dental School, Sao Paulo State University (UNESP), São Paulo, Brazil
| | - Jorge Esquiche León
- Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Ribeirão Preto, Brazil
- Department of Pathology and Forensic Medicine, Ribeirão Preto Medical School (FMRP/USP), University of São Paulo, Ribeirão Preto, Brazil
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5
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Zhu Y, Li S, Zhou L, Liu Z. Adult upper-limb forearm lymphoma hygroma (cystic lymphangioma): A case report. Int J Surg Case Rep 2023; 106:108200. [PMID: 37080154 PMCID: PMC10140781 DOI: 10.1016/j.ijscr.2023.108200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION Lymphoma hygroma (LH) that is the most common type of lymphangioma, but it rarely occurs in the forearm. It may show localized invasive behavior, but is benign. CASE PRESENTATION A 42-year-old woman presented to our hospital with a growing strip-like mass in the right forearm that had been detected 3 years earlier. Ultrasound examination showed a subcutaneous strip of low back vocal cords on the right forearm. Further magnetic resonance imaging (MRI) showed irregular strip-like dilated lymphatic vessels characteristic of LH with low T1 signal intensity and high T2 signal intensity. After radical surgical resection, hematoxylin-eosin (H & E) and immunohistochemical (IHC) staining of cystic LH endothelial cells labeled with monoclonal antibody D2-40 showed a dilated lymphangioma with no evidence of malignancy. After 7 months of follow-up, no tumor recurrence was seen and the effect was satisfactory. CLINICAL DISCUSSION A combination of previous trauma history, signs and symptoms, and imaging evaluation are necessary to provide clues to LH, but the final diagnosis is likely to be made by pathologic evaluation of the resected specimen. Although there are many treatment modalities, all also have different outcomes. The absence of complete resection resulting in a tumor remnant is the foremost cause of LH recurrence, so we believe that the preferred approach against LH remains complete surgical resection. CONCLUSIONS LH is benign and generally asymptomatic lesions with mild bio-behavior. As there are occasional confusing presentations, similar cystic lesions should still be considered with caution for the disease. Although MRI provides superior advantages for its diagnosis, the confirmation of diagnosis still requires histological examination. Radical lesion resection is a very safe and effective option for the treatment of LH.
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Affiliation(s)
- Yingkang Zhu
- Department of Orthopedics, The Fourth Affiliated Hospital, China Medical University, Shenyang 110031, Liaoning Province, China; Department of orthopedic and soft tissue surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, Shandong Province, China.
| | - Sufen Li
- Department of Orthopedics, The Fourth Affiliated Hospital, China Medical University, Shenyang 110031, Liaoning Province, China; Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, Shandong Province, China
| | - Lei Zhou
- Department of Orthopedics, The Fourth Affiliated Hospital, China Medical University, Shenyang 110031, Liaoning Province, China; Department of orthopedic and soft tissue surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, Shandong Province, China
| | - Zunpeng Liu
- Department of Orthopedics, The Fourth Affiliated Hospital, China Medical University, Shenyang 110031, Liaoning Province, China.
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Debelenko L, Mansukhani MM, Remotti F. Papillary Intralymphatic Angioendothelioma in a Child With PIK3CA-Related Overgrowth Spectrum: Implication of PI3K Pathway in the Vascular Tumorigenesis. Pediatr Dev Pathol 2023; 26:166-171. [PMID: 36775953 DOI: 10.1177/10935266231152370] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Papillary intralymphatic angioendothelioma (PILA) is an extremely rare vascular tumor and its pathogenesis is unknown. Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA)-related overgrowth spectrum (PROS) is a heterogeneous group of disorders caused by mosaicism for activating mutations of PIK3CA and characterized by asymmetric overgrowth, skeletal anomalies, skin lesions, and vascular malformations. An association between PILA and PROS has not been known. We report a case of PILA involving the spleen of a young girl with the clinical and molecular diagnosis of PROS. Sequencing of the patient's germ-line DNA detected a pathogenic PIK3CA variant c.1357G>A in 10.6% of alleles. Splenectomy revealed a 4-cm tumor composed of ectatic lymphatics with intraluminal papillary projections, consistent with PILA. The tumor cells showed immunohistochemical expression of CD31, CD34, ERG, FLI-1, PROX1, and caldesmon, while D2-40 was negative. The latter may suggest that the tumor derived from an endothelial precursor arrested in the final steps of lymphothelial differentiation, in keeping with the known role of the PIK3CA-governed molecular pathway in the progression of vascular progenitors to mature endothelial cells. The data implicates PIK3CA in the pathogenesis of PILA and broadens the spectrum of phenotypic expressions of PROS.
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Affiliation(s)
- Larisa Debelenko
- Department of Pathology and Cell Biology, Columbia University-Irving Medical Center, New York, NY, USA
| | - Mahesh M Mansukhani
- Department of Pathology and Cell Biology, Columbia University-Irving Medical Center, New York, NY, USA
| | - Fabrizio Remotti
- Department of Pathology and Cell Biology, Columbia University-Irving Medical Center, New York, NY, USA
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Xu J, Wang X, Du Q, Qu P, Liu C. Clinical Significance of Lymphatic Infiltration Detected by Immunohistochemical Double Staining in Patients with Endometrial Cancer. Clin Med Insights Oncol 2023; 17:11795549231152308. [PMID: 36744170 PMCID: PMC9896085 DOI: 10.1177/11795549231152308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 01/05/2023] [Indexed: 02/04/2023] Open
Abstract
Background The presence of lymph-vascular space invasion is a powerful predictor of lymph node metastasis. However, most studies do not distinguish lymph vessel invasion (LVI) and blood vessel invasion (BVI). The aim of this study was to distinguish the role of LVI and BVI in lymphatic metastasis and recurrence in patients with endometrial cancer. Methods We examined 171 patients with endometrial cancer. Immunohistochemical double staining was used to distinguish lymphatic invasion and vascular invasion. First, the relationship between lymphatic/vascular invasion and clinicopathological features and lymphatic metastasis was studied. Then, the expression of D2-40/LVI and CD31/BVI in patients with recurrence was analyzed. Results Pathological grading (G3) and D2-40/LVI were independent high-risk factors for lymph node metastasis of endometrial cancer. The area under the receiver operating characteristic curve values for predicting lymphatic metastasis using pathological grading (G3) or D2-40/LVI alone were .642 and .680, respectively, and the area under the curve value for the combined detection of pathological grading (G3) and D2-40/LVI was .726, which was greater than the values obtained for the abovementioned independent variables. Among the 15 recurrent patients, 5 (33.3%) were D2-40/LVI positive, 2 (13.3%) were CD31/BVI positive, and 8 (53.3%) were both D2-40/LVI and CD31/BVI positive. Conclusion D2-40/LVI combined with G3 can effectively predict lymph node metastasis of endometrial carcinoma.
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Affiliation(s)
- Juan Xu
- Department of Gynecologic Oncology,
Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, China,Tianjin Medical University, Tianjin,
China
| | - Xinmei Wang
- Department of Gynecologic Oncology,
Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, China
| | - Qiuyue Du
- Department of Gynecologic Oncology,
Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, China
| | - Pengpeng Qu
- Department of Gynecologic Oncology,
Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, China
| | - Caiyan Liu
- Department of Gynecologic Oncology,
Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, China,Caiyan Liu, Department of Gynecologic
Oncology, Tianjin Central Hospital of Gynecology Obstetrics, No. 156, Nankai
Third Road, Nankai District, Tianjin 300100, China.
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Oshikiri H, Ozawa Y, Suzuki O, Usuda M, Miyata G. Benign multicystic peritoneal mesothelioma occurring in bilateral inguinal canals metachronously: a case report. Surg Case Rep 2022; 8:44. [PMID: 35292863 PMCID: PMC8924337 DOI: 10.1186/s40792-022-01399-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Benign multicystic peritoneal mesothelioma (BMPM) is a benign tumor that usually occurs in middle-aged females. Although several published studies have reported the occurrence of this tumor in the abdominal cavity, few have documented its development in the inguinal region. CASE PRESENTATION We present a case of a 48-year-old female presenting with a bulge in her left inguinal region. Physical examination revealed a golf ball-sized nodule in the left inguinal region that could not be pushed back into the abdominal cavity. Contrast-enhanced computed tomography showed a multicystic tumor; therefore, the patient was diagnosed with inguinal hernia or hydrocele of the Nuck's canal. We performed surgical resection and hernia repair using the mesh plug method. The resected specimen was 80 mm in length and contained a multicystic tumor. Pathological examination showed that the cyst wall was lined by a single layer of cuboidal to single layer squamous epithelium. Immunohistochemistry revealed positivity for calretinin in the epithelial cells, for which a diagnosis of BMPM was established. The patient returned to our hospital after 5 years with symptoms similar to the previous episode, but this time in the right inguinal region. Imaging studies showed a tumor in the right inguinal region with the same characteristics as the previous one. The patient underwent tumor resection and hernia repair using the same technique. The resected tumor was 45 mm in length and had characteristics similar to the previously resected tumor. The presence of calretinin and D2-40 on immunohistochemistry led to the diagnosis of BMPM. There was no recurrence of BMPM for 33 months after the secondary surgery. CONCLUSIONS Here we present the first report of metachronous BMPM occurring in bilateral inguinal canals. Although the pathogenesis of BMPM remains unclear, reactive changes have been suggested to cause tumors originating from the groin. The treatment of choice for BMPM is surgical resection. For diagnosis, pathological examination with immunostaining can be useful. The most appropriate postoperative follow-up for inguinal BMPM is controversial, and the accumulation of more inguinal BMPM cases is needed.
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Affiliation(s)
- Hiroyuki Oshikiri
- Department of Digestive Surgery, Iwate Prefectural Central Hospital, 1-4-1, Ueda, Morioka, Iwate, 020-0066, Japan. .,Department of Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
| | - Yohei Ozawa
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - On Suzuki
- Department of Digestive Surgery, Iwate Prefectural Central Hospital, 1-4-1, Ueda, Morioka, Iwate, 020-0066, Japan
| | - Masahiro Usuda
- Department of Digestive Surgery, Iwate Prefectural Central Hospital, 1-4-1, Ueda, Morioka, Iwate, 020-0066, Japan
| | - Go Miyata
- Department of Digestive Surgery, Iwate Prefectural Central Hospital, 1-4-1, Ueda, Morioka, Iwate, 020-0066, Japan
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Martin SG, Rakha E, Storr SJ. Quantifying Lymphatic Vessel Density in Human Tissue Samples. Methods Mol Biol 2022; 2441:183-189. [PMID: 35099737 DOI: 10.1007/978-1-0716-2059-5_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The development of new blood and lymphatic vessels, through the process of angiogenesis and lymphangiogenesis, respectively, is critical to the development and growth of tumors, and integral to the process of metastasis. Lymphatic vessel density can be assessed as a surrogate measure of lymphangiogenesis in human tissue samples. Lymphatic vessel density has been shown to be associated with lymph node metastasis and patient survival in various solid tumor types. Here we describe a method for quantifying the number of lymphatic vessels within tumor tissue that can also be used to assess lymphatic vessel invasion, and compare with blood vessel density and invasion.
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Affiliation(s)
- Stewart G Martin
- Nottingham Breast Cancer Research Centre, Biodiscovery Institute, School of Medicine, University of Nottingham, Nottingham, UK
| | - Emad Rakha
- Nottingham Breast Cancer Research Centre, Biodiscovery Institute, School of Medicine, University of Nottingham, Nottingham, UK
| | - Sarah J Storr
- Nottingham Breast Cancer Research Centre, Biodiscovery Institute, School of Medicine, University of Nottingham, Nottingham, UK.
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10
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Chutipongpisit K, Parachuru VP, Friedlander LT, Hussaini HM, Rich AM. Immunohistochemical and immunofluorescence expression profile of lymphatic endothelial cell markers in oral cancer. Int J Exp Pathol 2021; 102:268-278. [PMID: 34791715 DOI: 10.1111/iep.12411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 06/06/2021] [Accepted: 08/08/2021] [Indexed: 12/19/2022] Open
Abstract
Lymphangiogenesis makes an important contribution to the tumour microenvironment (TME), but little is known about this in oral squamous cell carcinoma (OSCC). Archival formalin-fixed paraffin-embedded specimens (28 OSCC, 10 inflamed and 6 normal oral mucosa controls) were processed using immunohistochemistry (IHC) with antibodies against lymphatic markers D2-40 (podoplanin), LYVE-1, VEGFR3 and Prox1. After the endothelial cells had been highlighted by the various markers for lymphatic endothelium, the positive stained cells and vessels were identified and counted in a systematic manner to determine microvessel density. Double-labelling immunofluorescence (DLIF) was used to investigate the specificity of D2-40 and LYVE-1 to lymphatic endothelial cells (LECs) as opposed to blood ECs. There was higher D2-40 and Prox1 lymphatic vessel density (P = .001) in the OSCC group when compared with both control groups. Some malignant keratinocytes expressed lymphatic markers, as did a much smaller number of epithelial cells in the control groups. DLIF showed that no vessels co-expressed D2-40/CD34 or LYVE/CD34. Some D2/40+ LVs were LYVE- . D2-40 was the most specific LEC marker in OSCC tissues. These results establish that the OSCC TME contains significantly more lymphatic vessels expressing D2-40 and Prox1 than the control groups, which may play a role in facilitating lymphatic invasion and metastases.
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Affiliation(s)
- Kullasit Chutipongpisit
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - V Praveen Parachuru
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Lara T Friedlander
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Haizal M Hussaini
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Alison M Rich
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Zhu X, Zhou G, Ni P, Jiang X, Huang H, Wu J, Shi X, Jiang X, Liu J. CD31 and D2-40 Contribute to Peritoneal Metastasis of Colorectal Cancer by Promoting Epithelial-Mesenchymal Transition. Gut Liver 2021; 15:273-283. [PMID: 32390409 PMCID: PMC7960977 DOI: 10.5009/gnl19407] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/12/2020] [Accepted: 03/25/2020] [Indexed: 12/30/2022] Open
Abstract
Background/Aims Colorectal cancer (CRC) patients often exhibit peritoneal metastasis, which negatively impacts their prognosis. CD31 and D2-40 have recently been suggested to be predictors of breast cancer prognosis, but their role in colorectal peritoneal metastasis (CRPM) remains unknown. Methods The expression profiles of CD31 and D2-40 were analyzed in CRC patients with or without CRPM and in CRC cell lines with increasing metastatic potential. Overexpression and short hairpin RNA knockdown assays were performed in CRC cells, and the effects of these alterations on epithelial-mesenchymal transition (EMT) in vitro, growth of xenograft tumors in vivo, and peritoneal metastasis potential in a mouse model of CRPM were examined. Results The expressions of CD31 and D2-40 were upregulated in CRC tumor tissues and was elevated further in tumor tissues from patients with CRPM. CD31 and D2-40 expression levels exhibited increasing trends parallel to the EMT potential of CRC cells. CD31 and D2-40 are essential for CRC cell EMT in vitro as well as for xenograft tumor growth and peritoneal metastasis in vivo. Conclusions CD31 and D2-40 contribute to CRPM by promoting EMT and may serve as prognostic markers and therapeutic targets for CRC, particularly in patients with peritoneal metastasis.
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Affiliation(s)
- Xinqiang Zhu
- Department of General Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Gang Zhou
- Department of Gastrointestinal Pancreatic Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Peng Ni
- Department of General Surgery, Suining County Hospital of Traditional Chinese Medicine, Suining, China
| | - Xuetong Jiang
- Department of General Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Hailong Huang
- Department of General Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Jianqiang Wu
- Department of General Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Xiaohong Shi
- Department of Pathology, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Xiaoling Jiang
- Department of Pathology, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Jianing Liu
- Department of Digestion, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
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12
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Faustino SES, Tjioe KC, Assao A, Pereira MC, Carvalho AL, Kowalski LP, Oliveira DT. Association of lymph vessel density with occult lymph node metastasis and prognosis in oral squamous cell carcinoma. BMC Oral Health 2021; 21:114. [PMID: 33706734 PMCID: PMC7948342 DOI: 10.1186/s12903-021-01459-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 02/15/2021] [Indexed: 12/23/2022] Open
Abstract
Background The aims of this study were to determine intra (ILVD) and peritumoral (PLVD) lymphatic vessel density (LVD), and to investigate the relationship of LVD with occult metastasis and prognosis. Methods Eighty-seven oral squamous cell carcinomas, in clinical stages I or II, arising in the tongue or floor of the mouth were stained with podoplanin. Lymphatic vessels were quantified in intra and peritumoral areas by sequential analysis and hot spot evaluation. Associations of the ILVD and PLVD with clinicopathologic parameters were determined by Chi-square or Fisher’s exact test. The 5 and 10-year survival rates were calculated by the Kaplan–Meier and compared using the log-rank test. Results No significant association was observed between ILVD or PLDV and clinicopathologic variables including occult lymph node metastasis, or clinical follow-up. However, ILVD showed a significant association with regional recurrence (p = 0.040). The perineural invasion was associated with PLVD (p = 0.041). Disease-specific (p = 0.044) and disease-free survivals (p = 0.016) had significant association with PLVD. Conclusions The intra or peritumoral lymphatic vessel density had no predictive value for occult lymph node metastasis in the early stages of oral cancer arising in the tongue or floor of mouth. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01459-6.
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Affiliation(s)
- Simone E S Faustino
- Department of Surgery, Stomatology, Pathology, and Radiology, Area of Pathology, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, 17012-901, Brazil
| | - Kellen C Tjioe
- Department of Surgery, Stomatology, Pathology, and Radiology, Area of Pathology, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, 17012-901, Brazil.,Oral Oncology Center, Aracatuba School of Dentistry, São Paulo State University (Unesp), Aracatuba, São Paulo , Brazil
| | - Agnes Assao
- Department of Surgery, Stomatology, Pathology, and Radiology, Area of Pathology, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, 17012-901, Brazil
| | - Michele C Pereira
- Federal University of São João Del Rei - Midwest Campus Dona Lindu, Divinópolis, Minas Gerais, Brazil
| | - André L Carvalho
- Department of Head and Neck Surgery, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Luiz P Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Hospital, São Paulo, São Paulo, Brazil
| | - Denise T Oliveira
- Department of Surgery, Stomatology, Pathology, and Radiology, Area of Pathology, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, 17012-901, Brazil.
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13
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Vosough Z, Golbini S, Sharbatdaran M, Hosseini A. D2-40 A Helpful Marker in Assessment of Lymphatic Vessel Invasion in Carcinoma of Breast. Iran J Pathol 2020; 16:96-102. [PMID: 33936219 PMCID: PMC8085290 DOI: 10.30699/ijp.2020.114511.2245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 10/04/2020] [Indexed: 11/26/2022]
Abstract
Background & Objective: Breast cancer is the most common malignancy among Iranian women and worldwide. Lymphatic vessel invasion (LVI) was found to be an independent prognostic factor in many carcinomas, including invasive carcinoma of the breast. The aim of this study was to compare the hematoxylin and eosin (H&E) staining method and use of the immunohistochemical (IHC) marker ofD2-40, for evaluation of LVI in breast carcinoma specimens. Methods: The study was conducted on 50 patients undergone surgery between the years 2010 and 2015 in Rohani Hospital, Babol, Iran with invasive carcinoma of the breast with Census sampling method. LVI was assessed by two surgical pathologists, using H&E- stained sections and two IHC markers, i.e., D2-40 and CD31. Results: LVI was detected in 25 (50%) patients by H&E and in 14 (28%) patients by D2-40. Twelve out of 25 patients with positive LVI in H&E were confirmed by D2-40 and 2 out of 25 patients with negative lymphatic vessel in H&E. Only one case showed weak staining of CD31 proving LVI. These results showed a significant difference between the H&E staining and D2-40 IHC study for LVI detection (P=0.004). Conclusion: The D2-40 IHC marker is helpful in the diagnosis and confirmation of LVI in invasive carcinoma of the breast. CD31 is not suitable for the evaluation of lymphatic vessels.
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Affiliation(s)
- Zeinab Vosough
- Student Committee Research, Babol University of Medical Sciences, Babol, Iran
| | - Shima Golbini
- Student Committee Research, Babol University of Medical Sciences, Babol, Iran
| | - Majid Sharbatdaran
- Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Akramossadat Hosseini
- Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.,Clinical Research Development Center, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran
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14
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Warnecke-Eberz U, Plum P, Schweinsberg V, Drebber U, Bruns CJ, Müller DT, Hölscher AH, Bollschweiler E. Neoadjuvant chemoradiation changes podoplanin expression in esophageal cancer patients. World J Gastroenterol 2020; 26:3236-3248. [PMID: 32684738 PMCID: PMC7336324 DOI: 10.3748/wjg.v26.i23.3236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 04/20/2020] [Accepted: 05/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Locally advanced adenocarcinoma of the esophagus (EAC) and squamous cell carcinoma (ESCC) result in a worse prognosis. Neoadjuvant treatment improves survival, however, only for responders. The transmembrane glycoprotein podoplanin is overexpressed in squamous cell carcinomas, miRNA-363 is associated to its regulation in head and neck cancer.
AIM To predict therapy response and prognosis markers, and targets for novel therapies would individualize treatments leading to more favourable outcomes.
METHODS Expression of podoplanin protein has been visualized by immunohistochemistry in surgical specimens of 195 esophageal cancer patients who underwent transthoracic esophagectomy: 90 ESCC and 105 EAC with clinical T2-3, Nx, M0. One hundred and six patients received neoadjuvant chemoradiation. RNA was extracted from paraffin-embedded tissue, and miRNA-363 quantified by real-time TaqMan-real-time-PCR. D2-40 mab staining of > 5% was scored as high podoplanin expression (HPE). We related podoplanin and miRNA-363 expression to histopathologic response after neoadjuvant treatment and clinicopathological characteristics, such as histological tumor type, survival rate or clinical tumor category.
RESULTS We confirmed expression of membrane-bound podoplanin in 90 ESCC patients. 26% showed HPE of > 5%. In addition, absence in EAC patients (only 2% with HPE) was shown. Lower podoplanin expression has been detected in resection-specimen of 58 ESCC patients after neoadjuvant (RTx/CTx) treatment, only 11% with HPE, compared to 50% HPE of 32 non-pretreated primary surgery patients, P = 0.0001. This difference of podoplanin expression was confirmed comparing pre-treatment biopsies with matching post-treatment surgical specimens, P < 0.001. Podoplanin has been identified as a prognostic marker in 32 patients that underwent primary surgery without neoadjuvant treatment. Low (0-5%) podoplanin expression was associated with better prognosis compared to patients with HPE, P = 0.013. Podoplanin expression has been associated with post-transcriptional regulation by miRNA-363. At a cut-off value of miR-363 < 7, lower miR-363 expression correlated with HPE in surgical tissue specimens of primary surgery patients, P = 0.013. Therefore, ESCC patients with miRNA-363 expression < 7 had a worse prognosis than patients expressing miRNA-363 ≥ 7, P = 0.049.
CONCLUSION Analysis of the molecular process that leads to decrease in podoplanin expression during neoadjuvant treatment and its regulation may provide novel markers and targets to improve targeted therapy of ESCC.
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Affiliation(s)
- Ute Warnecke-Eberz
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne 50937, Germany
| | - Patrick Plum
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne 50937, Germany
| | - Viola Schweinsberg
- Department of Dermatology, University Hospital of Cologne, Cologne 50937, Germany
| | - Uta Drebber
- Institute of Pathology, University Hospital of Cologne, Cologne 50937, Germany
| | - Christiane J Bruns
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne 50937, Germany
| | - Dolores T Müller
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne 50937, Germany
| | | | - Elfriede Bollschweiler
- Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Cologne 50937, Germany
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15
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Gülseren D, Gököz Ö, Karahan S, Karaduman A. Podoplanin expression in cutaneous squamous cell carcinomas and its relationship to histopathological prognostic factors. J Histotechnol 2020; 43:147-152. [PMID: 32496961 DOI: 10.1080/01478885.2020.1757872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
There are several clinicopathological factors associated with the prognosis of cutaneous squamous cell carcinomas (cSCC), but there remains a lack of molecular markers associated with cSCC tumor progression. This study aimed to determine the association between histopathological prognostic parameters and tumoral podoplanin expression in cSCC. This study included 63 paraffin embedded cSCC samples that were evaluated for tumoral podoplanin expression using immunohistochemistry. Among the 63 tumor samples, 27% lacked podoplanin expression, 22% exhibited diffuse podoplanin expression, and 51% exhibited focal podoplanin expression. Tumoral podoplanin expression was correlated with lymphovascular invasion and lymph node metastasis (p value < 0.05, for both). Additional research is needed to further delineate how the tumoral podoplanin expression can be used as a prognostic marker in patients with cSCC.
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Affiliation(s)
- Duygu Gülseren
- Department of Dermatology, School of Medicine, Hacettepe University , Ankara, Turkey
| | - Özay Gököz
- Department of Pathology, School of Medicine, Hacettepe University , Ankara, Turkey
| | - Sevilay Karahan
- Department of Biostatistics, School of Medicine, Hacettepe University , Ankara, Turkey
| | - Ayşen Karaduman
- Department of Dermatology, School of Medicine, Hacettepe University , Ankara, Turkey
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16
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Cheuk W, Shum KS, Ng WK, Chan JKC. Composite Hemangioendothelioma With Neuroendocrine Marker Expression: Report of a "Paraganglioma-Like" Paravertebral Case. Int J Surg Pathol 2020; 28:759-763. [PMID: 32418470 DOI: 10.1177/1066896920924120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Composite hemangioendothelioma is a rare vascular tumor morphologically comprising several distinct vascular components and exhibits a borderline malignant potential. We described the case of a 53-year-old female who presented with an infiltrative mass in the paravertebral soft tissue. The tumor showed discrete nests of synaptophysin-expressing epithelioid cells accompanied by rich vasculature, features highly reminiscent of sympathetic paraganglioma. Further analysis revealed areas resembling spindle cell hemangioma, retiform hemangioendothelioma, cavernous hemangioma/lymphangioma, and epithelioid hemangioendothelioma without the myxohyaline matrix in the tumor, and a final diagnosis of composite hemangioendothelioma with synaptophysin expression was made. Critical appraisal of this recently described entity and its possible pathogenic relationship with retiform hemangioendothelioma were discussed.
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Affiliation(s)
- W Cheuk
- Queen Elizabeth Hospital, Hong Kong SAR China
| | - K S Shum
- St Teresa's Hospital, Hong Kong SAR China
| | - W K Ng
- St Teresa's Hospital, Hong Kong SAR China
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17
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Takada K, Yoshida M, Aizawa D, Sato J, Ono H, Sugino T. Lymphovascular invasion in early gastric cancer: impact of ancillary D2-40 and elastin staining on interobserver agreement. Histopathology 2020; 76:888-897. [PMID: 31989674 DOI: 10.1111/his.14075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/09/2020] [Accepted: 01/22/2020] [Indexed: 12/12/2022]
Abstract
AIMS Lymphatic invasion (LI) and venous invasion (VI) are the strongest risk factors for lymph node metastasis in patients with early gastric cancer, and may predict their prognosis. We aimed to investigate interobserver agreement among pathologists before and after adding ancillary staining for diagnosing LI and VI in this setting. METHODS AND RESULTS This retrospective study included 100 specimens of submucosal invasive gastric cancer from 100 patients treated using endoscopic resection. Three pathologists (expert, intermediate and trainee experience levels) independently evaluated individual LI and VI status using haematoxylin and eosin (H&E)-stained slides, and re-evaluated their decisions by reviewing corresponding D2-40-stained and elastin-stained slides. Interobserver agreement was assessed using κ statistics. With the ancillary D2-40 staining, there was an improved agreement for LI diagnoses between the expert and intermediate pathologist (H&E κ = 0.78, D2-40 κ = 0.85) and between the expert and trainee pathologist (H&E κ = 0.37, D2-40 κ = 0.56). With the ancillary elastin staining, there was an improved agreement for VI diagnoses between the expert and intermediate pathologists (H&E κ = 0.25, elastin κ = 0.63) and between the expert and trainee pathologists (H&E κ = 0.29, elastin κ = 0.45). CONCLUSIONS With both the ancillary D2-40 and elastin staining there was an improved interobserver agreement for LI and VI diagnoses, regardless of the pathologist's experience. This ancillary staining may be useful in improving the accuracy of LI and VI diagnoses, helping to improve the risk stratification of early gastric cancer patients.
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Affiliation(s)
- Kazunori Takada
- Department of Pathology, Shizuoka Cancer Center, Shizuoka, Japan.,Department of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Masao Yoshida
- Department of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Daisuke Aizawa
- Department of Pathology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Junya Sato
- Department of Pathology, Shizuoka Cancer Center, Shizuoka, Japan.,Department of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Hiroyuki Ono
- Department of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Takashi Sugino
- Department of Pathology, Shizuoka Cancer Center, Shizuoka, Japan
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18
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Caruana M, Morand M, Belisle A, Nantel-Battista M. Basal cell carcinoma stroma as a mimicker of lymphatic invasion: A case report. SAGE Open Med Case Rep 2020; 8:2050313X20919602. [PMID: 32477557 PMCID: PMC7234329 DOI: 10.1177/2050313x20919602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Basal cell carcinoma metastases are rare. We report a case of an 83 year-old male with recurrent cutaneous infiltrative basal cell carcinoma on the right vertex with tumor aggregates of infiltrative basal cell carcinoma in the lymphatic vessels of the superficial dermis strongly suspected on pathology slide evaluation during Mohs micrographic surgery. D2-40 immunohistochemical stain allows the detection of lymphatic invasion by highlighting endothelial cells. Further histologic review and D2-40 stains performed on the paraffin-embedded sections did not reveal an endothelial cell lining in favor of lymphatic invasion. What was identified as lymphatic invasion was the result of a peculiar basal cell carcinoma stroma. Correct identification of basal cell carcinoma stroma as a mimicker of lymphatic invasion would prevent potentially invasive investigation as well as associated costs. This is of great importance as the prognostic and therapeutic implications can be of significant value for the patient.
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Affiliation(s)
- Marco Caruana
- Department of Dermatology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Meggie Morand
- Department of Dermatology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Annie Belisle
- Department of Pathology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Mélissa Nantel-Battista
- Department of Dermatology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
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19
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Voelker HU, Hintermeier I, Strehl A, Scheich M. Prognostic Potential of the Expression of Podoplanin ( D2-40) Within Cells of Squamous Cell Carcinoma of the Larynx and Hypopharynx. World J Oncol 2020; 11:65-71. [PMID: 32284774 PMCID: PMC7141162 DOI: 10.14740/wjon1259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 02/18/2020] [Indexed: 11/11/2022] Open
Abstract
Background Podoplanin (D2-20) stains immunohistochemically lymphatic vessels, regular mesothelium and tumor cells of different tumors, e.g. malignant mesothelioma or seminoma. In squamous cell carcinoma (SCC), the marker has been described as variously expressed. Methods This study has investigated the value of the immunohistochemical analysis for the prognostic relevance of the expression in 119 SCCs of the larynx and hypopharynx. The clinical data and documentation of follow-up for at least 5 years were available. Results The collective showed the expected distribution of patient age with accentuation of the male sex and a balanced spread of tumor stages including nodal status. The immunohistochemical stain intensity (negative, weak or strong) and the distribution (equal versus focal) were evaluated. In addition, the accentuation of the staining reaction was separately examined at the border of invasion. SCCs with a strong expression of podoplanin were associated with an unfavorable prognosis. A comparison of grouped cases showed a trend emerging with borderline results (negative to weakly positive, P = 0.51; negative to strongly positive, P = 0.054; weakly positive to strongly positive, P = 0.17). The staining at the border of invasion had no statistical effect on overall survival. Multivariate survival statistics however showed that lymphonodal metastasis and a reaction with podoplanin in tumor cells are associated with significant worse prognosis. Conclusion In summary, regardless of the exact function of podoplanin in the process of cell migration and tumor progression, an immunohistochemical identification of expression in tumor cells of SCC of the larynx and hypopharynx can give additional information about the expectable prognosis.
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Affiliation(s)
- Hans-Ullrich Voelker
- Department of Pathology, Leopoldina Krankenhaus GmbH, Gustav-Adolf-Str. 8, D-97422 Schweinfurt, Germany
| | - Isabelle Hintermeier
- Department of Pathology, Leopoldina Krankenhaus GmbH, Gustav-Adolf-Str. 8, D-97422 Schweinfurt, Germany
| | - Annette Strehl
- Department of Pathology, Leopoldina Krankenhaus GmbH, Gustav-Adolf-Str. 8, D-97422 Schweinfurt, Germany
| | - Matthias Scheich
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital of Wuerzburg, Josef-Schneider-Str. 2, D-97080 Wuerzburg, Germany
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20
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Koochek Dezfuli M, Seyedmajidi M, Nafarzadeh S, Yazdani F, Bijani A. Angiogenesis and Lymphangiogenesis in Salivary Gland Adenoid Cystic Carcinoma and Mucoepidermoid Carcinoma. Asian Pac J Cancer Prev 2019; 20:3547-3553. [PMID: 31870093 PMCID: PMC7173365 DOI: 10.31557/apjcp.2019.20.12.3547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/25/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND PURPOSE This study aimed to investigate the immunohistochemical expression of CD31 and podoplanin in order to examine angiogenesis and lymphangiogenesis, respectively in common malignant tumors of salivary glands. MATERIALS AND METHODS Forty formalin-fixed, paraffinated blocks (20 adenoid cystic carcinoma and 20 mucoepidermoid carcinoma blocks) were selected from the medical archives of Amir A'lam Hospital of Tehran, Iran. Sections from the blocks were stained by CD31 and D2-40 markers via immunohistochemistry. Clinical and demographic information was extracted from the patients' records. FINDINGS There was a significant difference between tumors in terms of intratumoral microvessel density (MVD) (P< 0.001), total MVD (P< 0.001), and intratumoral lymphatic vessel density (LVD) (P= 0.011). In mucoepidermoid carcinoma, intratumoral MVD and LVD were greater than peritumoral MVD and LVD (P= 0.001 and P< 0.001, respectively). In mucoepidermoid carcinoma, there was no relationship between histological grade with MVD (total, intratumoral or peritumoral) or LVD (total, intratumoral or peritumoral) (P> 0.05). A similar finding was reported with respect to the histopathological grade of adenoid cystic carcinoma (P> 0.05). CONCLUSION The higher level of angiogenesis and lymphangiogenesis in mucoepidermoid carcinoma, specifically at the center of tumor, compared to adenoid cystic carcinoma, may be attributed to differences in the clinical behaviors and metastasis of tumors. Moreover, considering the high LVD at the center of tumor in mucoepidermoid carcinoma and infrequency of metastasis to regional lymph nodes in adenoid cystic carcinoma, it can play a significant role in metastasis to regional lymph nodes.
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Affiliation(s)
- Mohammad Koochek Dezfuli
- Department of Oral and Maxillofacial Pathology, Mazandaran University of Medical Sciences, Sari,
| | | | - Shima Nafarzadeh
- Oral health Research Center, Health Research Institute, Dental Faculty,
| | - Farzad Yazdani
- Non-Communicable Pediatrics’ Disease Research Center, Institute of Health, Babol University of Medical Sciences, Babol,
| | - Ali Bijani
- Department of Pathology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Nagano H, Kimura T, Iida A, Togawa T, Goi T, Sato Y. Cystic lymphangioma in the peripheral jejunal mesentery in an adult and excision with laparoscopic-assisted surgery: a case report. World J Surg Oncol 2019; 17:170. [PMID: 31651341 PMCID: PMC6814111 DOI: 10.1186/s12957-019-1713-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 09/20/2019] [Indexed: 12/14/2022] Open
Abstract
Background Lymphangiomas are uncommon congenital malformations that present mainly in the head, neck, and axillar regions in pediatric patients. Mesenteric cystic lymphangiomas (MCLs), which occasionally present with substantial growth and the invasion of adjacent vital structures, are rarely reported in adults. We report a case of MCL in an adult who was treated with laparoscopic-assisted excision. Case presentation A 40-year-old Japanese man visited his family physician for prolonged periumbilical pain. Plain computed tomography (CT) showed a low-density mass in his left abdomen, and he was referred to our hospital 2 weeks later. His abdomen was flat and soft, and no mass was felt upon palpation. Routine laboratory data showed no abnormalities in the blood cell counts. The levels of tumor markers, such as carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and cancer antigen 125 (CA125), were within normal ranges. Contrast-enhanced CT was performed, and a low-density mass was observed with an irregular outline and poor contrast, as well as involvement of the peripheral mesenteric artery and partial compression of the adjacent jejunum without dilatation of the oral side of the bowel. The patient was diagnosed with lymphatic cysts and observed for 1 month without symptom exacerbation. Follow-up CT showed no increase in the size of the mass but showed apparent invasion of the jejunal wall without bowel obstruction. Magnetic resonance imaging (MRI) showed intermediate intensity on T1-weighted imaging (T1WI) and high intensity on T2-weighted imaging (T2WI). The coronal view on T2WI clearly showed an accumulation of cystic lesions. We performed tumor excision with partial resection of the jejunum in a laparoscopic-assisted manner. Pathological examination showed multicystic lesions with an attenuated endothelial lining, surrounding rich adipose tissue and scattered smooth muscle fibers; the patient was diagnosed with MCL. Immunohistochemical assays supported this diagnosis. Conclusions This is rare case of MCL presenting in an adult who underwent successful laparoscopic-assisted resection. Mesenteric lymphangioma (ML) should be considered in the differential diagnosis of patients with intraabdominal cysts. Radical excision is optimal, even when the patient is asymptomatic. Laparoscopic-assisted tumor resection is a suitable surgical method for treating MLs located in the peripheral mesentery.
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Affiliation(s)
- Hideki Nagano
- Department of Surgery, National Hospital Organization Tsuruga Medical Center, 33-1, Sakuragaoka, Tsuruga, Fukui, 914-0195, Japan.
| | - Toshihisa Kimura
- Department of Surgery, National Hospital Organization Tsuruga Medical Center, 33-1, Sakuragaoka, Tsuruga, Fukui, 914-0195, Japan
| | - Atsushi Iida
- Department of Surgery, National Hospital Organization Tsuruga Medical Center, 33-1, Sakuragaoka, Tsuruga, Fukui, 914-0195, Japan
| | - Tamotsu Togawa
- Department of Surgery, National Hospital Organization Tsuruga Medical Center, 33-1, Sakuragaoka, Tsuruga, Fukui, 914-0195, Japan
| | - Takanori Goi
- First Department of Surgery, Faculty of Medicine, University of Fukui, 23-3, Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Yasunori Sato
- Department of Human Pathology Kanazawa University Graduate School of Medicine, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
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Nakagawa A, Fujimoto H, Nagashima T, Sangai T, Takada M, Masuda T, Teranaka R, Ota S, Matsushima J, Akita S, Ohtsuka M. Histological features of skin and subcutaneous tissue in patients with breast cancer who have received neoadjuvant chemotherapy and their relationship to post-treatment edema. Breast Cancer 2020; 27:77-84. [PMID: 31346921 DOI: 10.1007/s12282-019-00996-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 07/14/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Lymphedema is a major complication of treatment for breast cancer. Although chemotherapy can cause lymphedema, there have been few reports about histological changes in skin and subcutaneous tissue after chemotherapy. The aim of our study was to determine whether chemotherapy affects blood and lymphatic vessels in the skin and subcutaneous fat and to investigate the relationship between these changes and extent of post-chemotherapy edema. METHODS We compared histological findings in skin and subcutaneous fat of mastectomy specimens from 38 patients who had received NAC (neoadjuvant chemotherapy) and 56 who had not (non-NAC) attending our institution from 2007 to 2016. Patients whose tumor may have affected the area examined were excluded. Blood and lymphatic vessels were identified by CD31 and D2-40, respectively. We assessed microvessel density (MVD), lymphatic microvessel density (MLVD), lumen cross-sectional area (LA), and amount of endothelium (AE) in blood and lymphatic vessels. To minimize surgical effects, we measured edema, defined as ≥ 15% thicker dorsal subcutaneous tissue than baseline, on the contralateral side. RESULTS MVD, LA, and AE of blood vessels were greater and MLVD not significantly different in the skin of NAC patients than in that of non-NAC patients. MVD was greater and AE of blood vessels less in subcutaneous fat of NAC patients than in that of non-NAC patients. Patients with edema had significantly less AE of blood vessels in skin than did those without it. CONCLUSIONS These pathological findings can help to identify patients who will develop edema and improve their treatment.
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Ghinea N, Robin B, Pichon C, Leclere R, Nicolas A, Chnecker C, Côté JF, Guillonneau B, Radu A. Vasa nervorum angiogenesis in prostate cancer with perineural invasion. Prostate 2019; 79:640-646. [PMID: 30663097 DOI: 10.1002/pros.23771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 12/31/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Perineural invasion (PNI) is generally accepted as a major route of cancer dissemination in malignancies associated with highly enervated organs. However, the effect of cancer cells on vasa nervorum remains unknown. We studied this effect in locally advanced prostate cancer, a high-risk feature associated with approximately 20% of prostate cancer specific mortality. METHODS We used immunohistochemistry for CD34, fibroblast growth factor-2 (FGF-2), FSHR, podoplanin, vascular endothelial growth factor (VEGF), and VEGFR-2 as well as histochemical methods to examine the vasa nervorum of nerves invaded by cancer cells in tissue samples from 85 patients. RESULTS The percentage of the nerve area occupied by CD34-positive vasa nervorum endothelial cells in nerves with PNI was much higher than in nerves without PNI (7.3 ± 1.2 vs 1.9 ± 0.4; P < 0.001 and 5.8 ± 0.6 vs 1.23 ± 0.8; P < 0.001 in pT3a and pT3b prostate cancer specimens, respectively). In 19/85 of the patients the CD34-positive vasa nervorum microvessels have a thick basement membrane, similar to the vessels in diabetic microangiopathy. This subendothelial layer contains collagen fibers. Vasa nervorum endothelia and Schwann cells express FGF-2 (nuclear localization) and FSHR (plasma membrane and cytoplasmic staining). Prostate cancer cells invading nerves express VEGF, a critical cytokine in tumor angiogenesis. The vasa nervorum of prostatic nerves with PNI did not express detectable levels of VEGFR-2. No podoplanin-positive lymphatic vessels were seen in nerves. CONCLUSION In locally advanced prostate cancer, PNI of cancer cells is associated with formation of new endoneurial capillaries and changes of vasa nervorum morphology.
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Affiliation(s)
- Nicolae Ghinea
- Institut Curie, Université de recherche Paris-Sciences-et-Lettres, Département Recherche Translationnelle, Equipe Angiogenèse tumorale, Paris, France
| | - Blaise Robin
- Institut Curie, Université de recherche Paris-Sciences-et-Lettres, Département Recherche Translationnelle, Equipe Angiogenèse tumorale, Paris, France
| | - Christophe Pichon
- Institut Curie, Université de recherche Paris-Sciences-et-Lettres, Département Recherche Translationnelle, Equipe Angiogenèse tumorale, Paris, France
| | - Renaud Leclere
- Hôpital Curie, Université de recherche Paris-Sciences-et-Lettres, Pôle de médicine diagnostique et théranostique, Paris, France
| | - André Nicolas
- Hôpital Curie, Université de recherche Paris-Sciences-et-Lettres, Pôle de médicine diagnostique et théranostique, Paris, France
| | - Caroline Chnecker
- Hôpital Lariboisière, Service d'Anatomie et de Cytologie Pathologiques, Paris, France
| | - Jean-François Côté
- Hôpital Pitié-Salpêtrière, Service d'Anatomie et de Cytologie Pathologiques, Paris, France
| | | | - Aurelian Radu
- Icahn School of Medicine at Mount Sinai, Department of Cell, Developmental and Regenerative Biology, New York, New York
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Zhang S, Chen X, Yuan L, Wang S, Moli D, Liu S, Wu Y. Immunohistochemical Evaluation of Histological Change in a Chinese Milroy Disease Family With Venous and Skin Abnormities. Front Genet 2019; 10:206. [PMID: 30941160 PMCID: PMC6433936 DOI: 10.3389/fgene.2019.00206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 02/26/2019] [Indexed: 11/27/2022] Open
Abstract
Background: Milroy disease (MD) is rare and autosomal dominant resulting from mutations of the vascular endothelial growth factor receptor-3 (VEGFR-3 or FLT4), which leads to dysgenesis of the lymphatic system. Methods: Here we report a Chinese MD family with 2 affected members of two generations. We identified the mutation of c.3075G>A in one allele of FLT4 in Chinese population firstly. The father and child presented lymphedema under knees both. Unfortunately, the child was premature delivered for a car accident of the mother and then died of asphyxia. Then we gathered the tissue of the lower-limb from the child with permission from the parents and ethic committee. We stained the tissue with lymphatic marker D2-40 and hematoxylin-eosin to explore the histological changes. Afterwards, we compared the results with a normal child who unfortunately died of premature delivery also. Results: It is firstly identified the mutation of FLT4: c.3075G>A in Chinese population, and the mutation Inherited in the lineage. The histological evaluation indicated: (1) The number of lymphatic vessels decreased; (2) The morphology and structure of lymphatic vessels was abnormal. And what is added to our knowledge: (1) Capillary hyperemia and phlebectasia is severe; (2) Vascular malformations; (3) The number of vascular endothelial cells and vascular smooth muscle cells decreased; (4) Large sheets of epidermis desquamated; (5) The numbers of cutaneous appendages reduced in MD. Conclusions: Based on the new findings, we assume that mutation of FLT4 not only affect the lymphogenesis, but also the angiogenesis, and epidermis structure.
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Affiliation(s)
- Sijia Zhang
- Department of Biochemistry and Molecular Biology, Center for DNA Typing, Air Force Medical University, Xi'an, China.,State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Implant Dentistry, School of Stomatology, Air Force Medical University, Xi'an, China
| | - Xihui Chen
- Department of Biochemistry and Molecular Biology, Center for DNA Typing, Air Force Medical University, Xi'an, China
| | - Lijuan Yuan
- Department of Biochemistry and Molecular Biology, Center for DNA Typing, Air Force Medical University, Xi'an, China.,Department of General Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Shuyan Wang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Implant Dentistry, School of Stomatology, Air Force Medical University, Xi'an, China
| | - Dangzhi Moli
- Department of Biochemistry and Molecular Biology, Center for DNA Typing, Air Force Medical University, Xi'an, China
| | - Shujuan Liu
- Department of Obstetrics and Gynecology, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Yuanming Wu
- Department of Biochemistry and Molecular Biology, Center for DNA Typing, Air Force Medical University, Xi'an, China
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25
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van Beek JGM, van den Bosch QCC, Naus N, Paridaens D, de Klein A, Kiliç E, Verdijk RM. Absence of Intraocular Lymphatic Vessels in Uveal Melanomas with Extrascleral Growth. Cancers (Basel) 2019; 11:E228. [PMID: 30781402 DOI: 10.3390/cancers11020228] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 02/10/2019] [Accepted: 02/12/2019] [Indexed: 02/03/2023] Open
Abstract
The aim of this study was to investigate the presence of intraocular lymphatic vessels in patients with uveal melanomas and extrascleral extension using a panel of lymphatic markers. The following immunohistochemical markers were analyzed: lymphatic vessel endothelial hyaluronic acid receptor-1 (LYVE-1), podoplanin (D2-40), prospero-related homeobox gene-1 (Prox-1), pan-endothelial marker cluster of differentiation 31 (CD31), and blood vessel endothelium-specific CD34. Lymphatic vessels were defined as a combination of staining of the following positive markers: LYVE-1, D2-40, Prox-1, and CD31; and no staining of the negative marker CD34. In total, 456 patients were enucleated; 16 of the 46 uveal melanomas with extrascleral extension were contained in stored paraffin tissue. Two samples of the 16 uveal melanomas showed focal positive intraocular vascular staining for LYVE-1 and co-expression of CD31 and CD34. Due to the lack of Prox-1 and D2-40, and positive expression of CD34, these cannot be classified as lymphatic vessels. In one case recruitment of an extraocular, intratumoral lymphatic vascular structure was observed in the periphery of the subconjunctival extrascleral extension. Intraocular lymphatic vessels are absent in uveal melanomas with extrascleral extension; however, we provide proof for recruitment of intratumoral lymphatics by uveal melanomas with extraocular extension from subconjunctival lymphatics that may explain the rare cases of regional lymphatic spread. A panel of antibodies is necessary to detect lymphatic vessels with high specificity.
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26
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de Vilhena AF, das Neves Pereira JC, Parra ER, Balancin ML, Ab Saber A, Martins V, Farhat C, Abrantes MM, de Campos JRM, Tedde ML, Takagaki T, Capelozzi VL. Histomorphometric evaluation of the Ki-67 proliferation rate and CD34 microvascular and D2-40 lymphovascular densities drives the pulmonary typical carcinoid outcome. Hum Pathol 2018; 81:201-210. [PMID: 30031097 DOI: 10.1016/j.humpath.2018.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/22/2018] [Accepted: 07/03/2018] [Indexed: 12/16/2022]
Abstract
Ki-67 has shown promise as a prognostic factor in pulmonary carcinoids. In this study, we sought to validate the importance of Ki-67 and study the relationships between Ki-67 and other stromal biomarkers of vascular density. We examined Ki-67, CD34, and D2-40 in tumor tissues from 128 patients with surgically excised typical carcinoid of the lung. We used immunohistochemistry and morphometry to evaluate the amount of tumor staining for cellular proliferation (Ki-67), microvascular density (CD34-MVD), and D2-40 lymphovascular density. The main outcome was overall survival, considered as life expectancy until death from metastasis. Specimens from patients with central tumors showed high CD34-MVD (P = .01), which was also significantly associated with a compromised surgical margin, lymph node metastasis, and clinical stage Ib. Equally significant was high D2-40 lymphovascular density in central specimens with a compromised surgical margin and lymph node metastasis. A high Ki-67 proliferation rate was significantly associated with tumors from patients with clinical stage IIb, IIIa, and IV disease. Multivariate Cox model analysis demonstrated that tumor location and stage, surgical margin, tumor size, and N stage were significantly related to survival time (P < .05). Quantitative staining of the tumor for Ki-67 and CD34-MVD served as prognostic factors (P < .05), which were more relevant than the surgical and pathological stage. Ki-67 greater than 5% and CD34-MVD greater than 7% staining comprise a subset of patients with higher death hazard; this outcome may harbor evidence for further prospective studies of target therapy after surgical resection.
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Affiliation(s)
| | | | - Edwin Roger Parra
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Marcelo Luiz Balancin
- Laboratory of Genomic and Histomorphometry, Department of Pathology, University of São Paulo Medical School, São Paulo 01246-903, Brazil
| | - Alexandre Ab Saber
- Laboratory of Genomic and Histomorphometry, Department of Pathology, University of São Paulo Medical School, São Paulo 01246-903, Brazil
| | - Vanessa Martins
- Laboratory of Genomic and Histomorphometry, Department of Pathology, University of São Paulo Medical School, São Paulo 01246-903, Brazil
| | - Cecilia Farhat
- Laboratory of Genomic and Histomorphometry, Department of Pathology, University of São Paulo Medical School, São Paulo 01246-903, Brazil
| | | | | | - Miguel Lia Tedde
- Department of Thoracic Surgery, Heart Institute (Incor), São Paulo 05403-000, Brazil
| | - Teresa Takagaki
- Division of Pneumology, Heart Institute (Incor), Faculty of Medicine, University of São Paulo, São Paulo 05403-000, Brazil
| | - Vera Luiza Capelozzi
- Laboratory of Genomic and Histomorphometry, Department of Pathology, University of São Paulo Medical School, São Paulo 01246-903, Brazil.
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Sasaki H, Morohashi S, Toba T, Seino H, Yoshizawa T, Hirai H, Haga T, Wu Y, Kijima H. Neoangiogenesis of gastric submucosa-invasive adenocarcinoma. Oncol Lett 2018; 16:3895-3900. [PMID: 30128004 PMCID: PMC6096252 DOI: 10.3892/ol.2018.9116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 02/07/2017] [Indexed: 02/01/2023] Open
Abstract
Early gastric cancer may be defined as mucosal or submucosal invasive carcinoma, and exhibits a good prognosis: 90% of patients survive >10 years. Early gastric cancer infrequently exhibits lymph node metastasis, although submucosal invasion, the presence of vascular invasion and/or lymphatic permeation are independent risk factors for lymph node metastasis in early gastric cancer. The analysis of tumor lymphangiogenesis and angiogenesis are important to determine the extent of invasive progression and metastasis in patients. Previously, the presence of vessels expressing the D2-40 antibody and the factor-VIII protein has been identified immunohistochemically. The vessels that are immunoreactive for D2-40 and factor-VIII are morphologically similar to lymphatic vessels or small-size veins, also termed venules. In the present study, the association between tumor invasion and neoangiogenesis in early gastric cancer was examined. The D2-40/factor-VIII double-stained vessel (DSV) density was analyzed, in addition to lymphatic and blood vessel (vein and artery) density, using 46 submucosa-invasive and 50 mucosal carcinomas, and 20 non-neoplastic gastric tissues. The lymphatic density and DSV density of submucosa beneath the carcinoma and submucosa of the surrounding region in submucosa-invasive carcinoma were significantly increased (P<0.001) in comparison with those in mucosal carcinoma or non-neoplastic gastric tissue. No significant difference was observed in blood vessel density between non-neoplastic gastric, mucosal carcinoma and submucosa-invasive carcinoma tissues other than that of mucosa. The present study suggests the potential for the presence of D2-40/factor-VIII DSV and the importance of this vessel for neoangiogenesis in early gastric cancer.
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Affiliation(s)
- Hanae Sasaki
- School of Medicine, Hirosaki University, Hirosaki, Aomori, 036-8560, Japan
| | - Satoko Morohashi
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan
| | - Takahito Toba
- Department of Internal Medicine, Toho University Ohmori Medical Center, Ohta, Tokyo 143-8541, Japan
| | - Hiroko Seino
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan.,Department of Radiology and Radiation Oncology Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan
| | - Tadashi Yoshizawa
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan
| | - Hideaki Hirai
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan
| | - Toshihiro Haga
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan
| | - Yunyan Wu
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan
| | - Hiroshi Kijima
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036-8562, Japan
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28
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Itami H, Nakamine H, Takeda M, Nakai T, Myojin T, Matsuoka M, Sasaki S, Uchiyama T, Morita K, Fujii T, Hatakeyama K, Ohbayashi C. Immunohistochemical Reappraisal Regarding the Frequency of Primary Salivary Gland Follicular Lymphoma. Int J Surg Pathol 2018; 27:48-54. [PMID: 29972093 DOI: 10.1177/1066896918784349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although it has been described that extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT lymphomas) are the most common type among primary salivary gland lymphomas (SGLs), some studies revealed that the frequency of follicular lymphomas (FLs) was as high as that of MALT lymphomas. However, it has been reported that many of these FLs may have developed in lymph nodes attached to the capsule of the glands or intraglandular lymph nodes. Clinical, histological, immunohistochemical, and cytogenetic features of 11 SGL cases, which were extracted from our surgical pathology file consisting of consecutive pathology cases, were reevaluated to further characterize whether they were actually primary SGLs. There were 3 (27%) cases of FLs, 5 (46%) cases of MALT lymphomas, and 3 (27%) cases of diffuse large B-cell lymphomas. Although all of our FL cases fulfilled the criteria of primary SGL, tumors of several FL cases were surrounded by podoplanin (by D2-40)-positive elongated vessels or linear structures indicative of nodal subcapsular sinuses (open or remnant). This finding would support the aforementioned possibility, and podoplanin staining is necessary before concluding that a FL is a primary SGL.
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Affiliation(s)
| | | | - Maiko Takeda
- 1 Nara Medical University, Kashihara, Japan.,3 National Hospital Organization Kinki-chuo Chest Medical Center, Sakai, Japan
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29
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Guleria P, Srinivas V, Basannar D, Dutta V. Comparison of lymphangiogenesis, lymphatic invasion, and axillary lymph node metastasis in breast carcinoma. INDIAN J PATHOL MICR 2018; 61:176-180. [PMID: 29676352 DOI: 10.4103/ijpm.ijpm_774_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context Lymphangiogenesis correlates with poor prognosis in Invasive Ductal Carcinoma (IDC) breast. D2-40 antibody, a specific marker for lymphatic endothelium, differentiates lymphatic from vascular endothelium. Therefore, the aims of this study were to estimate lymphangiogenesis using D2-40 antibody and correlate with lymphatic invasion (LI) and axillary lymph node (LN) status and compare lymphatic mean vessel density (LMVD) with Tumor (T) and Node (N) stages and grade of tumor. Methods and Material The study was conducted on fifty consecutive cases of IDC breast who underwent modified radical mastectomy (MRM) from Jan 2009 to March 2011. Hematoxylin-eosin sections and Immunohistochemistry (IHC) slides were studied along with their LN status. LMVD was counted after D2-40 immunostaining (100x magnification) in three hot spots in peritumoral areas and averaged. LI as opposed to vascular invasion (BVI), and LN status for all cases were assessed. Statistical Analysis Statistical analysis was done using SPSS software (version 14.0 for Windows). Pearson's correlations, χ2 tests and Mann-Whitney U test were used. Results Lymphangiogenesis varied from 0 to 58 with mean LMVD of 11. Of 50 cases, five showed no lymphatic vessels in peritumoral areas; of these five, three had positive LNs. 21/50 cases had LI. No statistical significant association was seen between lymphangiogenesis and LI. 34/50 cases had positive LNs. Mean LMVD was higher in patients with N2/N3 stage as compared to N0/N1 stage and was statistically significant (P = 0.013). Conclusions D2-40 is specific marker for lymphatic endothelium. LI and lymphangiogenesis, as opposed to BVI, are better prognostic indicators in IDC breast.
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Affiliation(s)
- Prerna Guleria
- Department of Pathology, Military Hospital Yol Cantt, Kangra, Himachal Pradesh, India
| | - V Srinivas
- Department of Pathology, Command Hospital (Southern Command), Pune, Maharashtra, India
| | - D Basannar
- Department of PSM, AFMC, Pune, Maharashtra, India
| | - Vibha Dutta
- Department of Pathology, Command Hospital (Central Command), Lucknow, Uttar Pradesh, India
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Al-Rohil RN, Milton DR, Nagarajan P, Curry JL, Feldmeyer L, Torres-Cabala CA, Ivan D, Prieto VG, Tetzlaff MT, Aung PP. Intratumoral and peritumoral lymphovascular invasion detected by D2-40 immunohistochemistry correlates with metastasis in primary cutaneous Merkel cell carcinoma. Hum Pathol 2018; 77:98-107. [PMID: 29601841 DOI: 10.1016/j.humpath.2018.03.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/12/2018] [Accepted: 03/19/2018] [Indexed: 12/21/2022]
Abstract
Primary cutaneous Merkel cell carcinoma (MCC) is an aggressive neuroendocrine malignancy in which lymphovascular invasion (LVI) correlates with more aggressive phenotype. The prognostic significance of LVI detected by D2-40 immunohistochemistry (IHC) in MCC remains controversial. We aimed to determine how LVI detected by D2-40 IHC compares with LVI detected by hematoxylin and eosin (H&E) staining in predicting MCC metastasis. Clinical and histopathologic features of MCCs diagnosed and treated in 2002 to 2015 were assembled and included 58 MCC tumors from 58 patients. H&E-stained tissue sections and D2-40 IHC studies were reviewed. When LVI was present, the location (peritumoral or intratumoral) and the size of the largest invaded vessel were recorded. LVI findings by H&E staining and D2-40 IHC were compared with each other and with histologic features and clinical outcomes. H&E staining showed LVI in 37 of 58 cases; D2-40 IHC confirmed LVI in 30 of these cases but failed to confirm LVI in 7. D2-40 IHC also detected 14 cases of LVI not identified on H&E staining. Histologically, D2-40-detected LVI was associated with infiltrative growth pattern and nonbrisk lymphoid infiltrate (P = .005 and P = .055, respectively). There was a statistically significant difference between the frequency of detection of peritumoral LVI by H&E in comparison to D2-40 IHC (P = .0009). MCCs in which D2-40 IHC-detected both intratumoral and peritumoral LVI were typically larger than MCCs without (mean, 24.5 mm versus 17.3 mm; P = .03) and more frequently metastasized (87% versus 51%; P = .03). D2-40 IHC detection of both intratumoral and peritumoral LVI is associated with metastasis.
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Affiliation(s)
- Rami N Al-Rohil
- Department of Pathology, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Denái R Milton
- Department of Biostatistics, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Priyadharsini Nagarajan
- Department of Pathology, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jonathan L Curry
- Department of Pathology, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; Department of Dermatology, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Laurence Feldmeyer
- Department of Pathology, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Carlos A Torres-Cabala
- Department of Pathology, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; Department of Dermatology, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Doina Ivan
- Department of Pathology, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; Department of Dermatology, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Victor G Prieto
- Department of Pathology, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; Department of Dermatology, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Michael T Tetzlaff
- Department of Pathology, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Phyu P Aung
- Department of Pathology, Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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Nijkang NP, Anderson L, Markham R, Fraser IS, Manconi F. Blood microvasculature and lymphatic densities in endometrial polyps and adjacent and distant endometrium. SAGE Open Med 2018; 6:2050312118761287. [PMID: 29568523 PMCID: PMC5858742 DOI: 10.1177/2050312118761287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 02/01/2018] [Indexed: 11/24/2022] Open
Abstract
Objective: Endometrial polyps are localised growths of endometrial tissue containing glands, stroma and blood vessels, covered with epithelium. The reported prevalence of endometrial polyps is dependent upon the population being studied and the uterine imaging technique utilised. The light microscopy literature provides very little information regarding their microvasculature and lymphatic systems; however, a plethora of ultrasound data demonstrating single central arteries in most medium- or large-sized endometrial polyps are well documented. Methods: Archived formalin-fixed paraffin-embedded blocks of endometrial curettings were retrieved from files for women with confirmed endometrial polyps (n = 20) and women with normal endometrium (control endometrium; n = 32). Immunohistochemistry was performed with the antibodies CD31 (blood vessels) and D2-40 (lymphatics). Blood vessels and lymphatics were quantified in endometrial polyps and adjacent, distant and control endometrium. Results: CD31 and D2-40 staining was present in all specimens, although there were no significant differences in blood vessel (F(3,70) = 2.36, p = 0.079) and lymphatic (F(3,70) = 0.16, p = 0.920) densities between endometrial polyps as well as adjacent, distant and control endometrium. There were also no significant differences in women with endometrial polyp-associated bleeding and those with no bleeding. In relation to infertility, there were no significant differences found in blood and lymphatic densities between women with endometrial polyps who were infertile and those with endometrial polyps who were fertile. Conclusion: Small blood vessel wall and perivascular structures rather than the distribution of vessels may be associated with abnormal bleeding.
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Affiliation(s)
- Njume Peter Nijkang
- Discipline of Obstetrics, Gynaecology and Neonatology, The University of Sydney, Sydney, NSW, Australia
| | - Lyndal Anderson
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Robert Markham
- Discipline of Obstetrics, Gynaecology and Neonatology, The University of Sydney, Sydney, NSW, Australia
| | - Ian Stewart Fraser
- School of Women's and Children's Health, Royal Hospital for Women, University of New South Wales, Sydney, NSW, Australia
| | - Frank Manconi
- Discipline of Obstetrics, Gynaecology and Neonatology, The University of Sydney, Sydney, NSW, Australia
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Kolay SK, Parwani R, Wanjari S, Singhal P. Oral lymphangiomas - clinical and histopathological relations: An immunohistochemically analyzed case series of varied clinical presentations. J Oral Maxillofac Pathol 2018; 22:S108-S111. [PMID: 29491618 PMCID: PMC5824501 DOI: 10.4103/jomfp.jomfp_157_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Lymphangiomas are benign malformations that represent hamartoma of malformed lymphatics and are composed of cystically dilated lymphatic channels which do not communicate or drain into other lymphatic channels or veins leading to accumulation of lymph. They are congenital malformations with rare occurrence in oral cavity within which tongue dorsum is the most affected site. Venous malformations are often difficult to differentiate from lymphatic malformations leading to the development of several lymphatic markers like D2-40 which seems to be useful for distinguishing vascular from lymphatic vessels. The most effective treatment is surgery having good prognosis for most of the patients but depending on their location (neck/tongue) and size (large size) they may cause airway obstruction causing death. Herewith, we present the rare cases of oral lymphangiomas of tongue, palate and buccal mucosa with varied and characteristic clinical presentations.
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Affiliation(s)
| | - Rajkumar Parwani
- Department of Oral and Maxillofacial Pathology, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India
| | - Sangeeta Wanjari
- Department of Oral and Maxillofacial Pathology, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India
| | - Pallav Singhal
- Department of Oral Pathology and Microbiology, Sarjug Dental College, Darbhanga, Bihar, India
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Roncati L, Manenti A, Pusiol T, Mataca E, Nosseir S, Piscioli F, Maiorana A, Barbolini G. Exploring the mesenteric lymphatic apparatus: A morphological and immunohistochemical investigation with clinical correlations. Lymphology 2018; 51:73-78. [PMID: 30253458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Modern immunohistochemical techniques allow a detailed study of the lymphatic system in many organs and areas of the body. We performed an in-depth study on lymphatic vessels of the ileal and colonic mesenteries, together with the greater omentum where they appear particularly numerous and mainly represented by capillaries interconnected among themselves and with lymph nodes. The capillary wall consists of a fine single sheath of endothelial cells wrapped around by a subtle collagen membrane and deprived of valves. The progression of lymph flow is promoted by external forces acting on the capillary walls. Only at the mesenteric roots can pre- and post-lymph nodal collector vessels be observed. Our observations help to explain different patho-physiological correlations and the possible presence of skip lymph node metastases.
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Affiliation(s)
- L Roncati
- Department of Diagnostic and Clinical Medicine, University of Modena and Reggio Emilia, Moderna, Italy
- Department of Public Health, University of Modena and Reggio Emilia, Moderna, Italy
- Provincial Health Care Services, Rovereto, Italy
| | - A Manenti
- Department of Diagnostic and Clinical Medicine, University of Modena and Reggio Emilia, Moderna, Italy
- Department of Public Health, University of Modena and Reggio Emilia, Moderna, Italy
- Department of Surgery and Surgical Specialities, University of Modena and Reggio Emilia, Moderna, Italy
- Provincial Health Care Services, Rovereto, Italy
| | - T Pusiol
- Provincial Health Care Services, Rovereto, Italy
| | - E Mataca
- Department of Diagnostic and Clinical Medicine, University of Modena and Reggio Emilia, Moderna, Italy
- Department of Public Health, University of Modena and Reggio Emilia, Moderna, Italy
| | - S Nosseir
- Department of Diagnostic and Clinical Medicine, University of Modena and Reggio Emilia, Moderna, Italy
- Department of Public Health, University of Modena and Reggio Emilia, Moderna, Italy
| | - F Piscioli
- Provincial Health Care Services, Rovereto, Italy
| | - A Maiorana
- Department of Diagnostic and Clinical Medicine, University of Modena and Reggio Emilia, Moderna, Italy
- Department of Public Health, University of Modena and Reggio Emilia, Moderna, Italy
- Department of Surgery and Surgical Specialities, University of Modena and Reggio Emilia, Moderna, Italy
- Provincial Health Care Services, Rovereto, Italy
| | - G Barbolini
- Department of Diagnostic and Clinical Medicine, University of Modena and Reggio Emilia, Moderna, Italy
- Department of Public Health, University of Modena and Reggio Emilia, Moderna, Italy
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34
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Abd El-Aal NF, Hamza RS, Magdy M. Anti-angiogenic and anti-lymphangiogenic role of praziquantel and artemether in experimental mansoniasis. Acta Parasitol 2017; 62:708-716. [PMID: 29035850 DOI: 10.1515/ap-2017-0085] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 06/28/2017] [Indexed: 12/15/2022]
Abstract
Angiogenesis is one of the pillars of neoplasia. Lymphangiogenesis in context of granulomas is not yet understood. This study aimed to evaluate the role of praziquantel (PZQ) and artemether (ART) as anti-angiogenic and anti-lymphangiogenic drugs in Schistosoma mansoni induced experimental hepatic model through immunohistochemical and serological studies, this can be used as a potential novel prophylactic approach in hepatic malignancy prevention and possible management. Forty female CD-1 Swiss albino mice were used divided into 4 groups (10 mice each); control healthy, control infected untreated, PZQ-treated and ART-treated. Angiogenic and lymphangiogenic effect of the drugs assessed pathologically through counting of the newly formed capillaries and lymphatics that immunohistochemically expressed by vascular Endothelial Growth Factor (VEGF), CD34 and D2-40 in liver sections using Cell Image Analyzer and serologically by evaluation of serum level of Tumor Necrosis Factor-Alpha (TNF-α). Our results showed significant decrease in serum TNF-α in ART-treated group compared to control infected and PZQ treated groups. ART exhibited significant anti-angiogenic role on granulomas illustrated by remarkable milder intensity and significantly lower expression values of VEGF and CD34 immunostaining compared to PZQ and non-treated groups. Also, ART treated group exhibited negative D2-40 expression in the granulomas in contrast to the other groups, supporting the potent ART' anti-lymphangiogenic role that exceeded PZQ. In conclusion, ART showed not only anti-angiogenic effect but also prominent anti-lymphangiogenic effect on hepatic S. mansoni granulomas compared to PZQ. Our study supports the potential use of ART as a potential novel prophylactic approach in hepatic malignancy prevention and possible management.
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35
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Grzegrzolka J, Wojtyra P, Biala M, Piotrowska A, Gomulkiewicz A, Rys J, Podhorska-Okolow M, Dziegiel P. Correlation Between Expression of Twist and Podoplanin in Ductal Breast Carcinoma. Anticancer Res 2017; 37:5485-5493. [PMID: 28982860 DOI: 10.21873/anticanres.11978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 08/03/2017] [Accepted: 08/04/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM As a result of activation of transcription factors engaged in epithelial-mesenchymal transition (EMT), such as Twist, inhibition of epithelial markers and an increased expression of mesenchymal markers are observed. One of the specific markers of cancer-associated fibroblasts is podoplanin (PDPN) - a mucin-type membrane glycoprotein. The aim of this work was to study the localisation and intensity of expression of Twist and PDPN on the mRNA and protein level in cases of invasive ductal breast carcinoma (IDC), and its association with patients' clinico-pathological data. MATERIALS AND METHODS The study included archival material in a form of 80 paraffin IDC blocks and 11 IDC fragments frozen in liquid nitrogen. Immunohistochemical expression of Twist and PDPN was evaluated using light microscope and semiquantitative scale for evaluation of nuclear expression or immunoreactive scale (IRS) for evaluation of cytoplasmic expression. Material was isolated from frozen IDC fragments using laser micro-dissection (from cancer and stromal cells, separately) and was used to perform real-time PCR. RESULTS Twist expression was higher in stromal cells in comparison to cancer cells. Analysis of patients' survival rate showed, that higher expression of Twist in cancer cells was associated with shorter overall survival time and shorter event-free survival time. The expression of PDPN was also higher in stromal cells in comparison with cancer cells. In addition, positive correlation was observed between expression of Twist and PDPN in stromal cells of IDC (r=0.267; p<0.05). CONCLUSION The relationship between the higher expression of Twist in both cancer and stromal cells and shorter patients' survival indicates Twist as a potential useful prognostic marker in IDC. Positive correlation of Twist and PDPN expression may indicate the role of PDPN in EMT in IDC.
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Affiliation(s)
- Jedrzej Grzegrzolka
- Department of Histology and Embryology, Wroclaw Medical University, Wroclaw, Poland
| | - Patrycja Wojtyra
- Department of Histology and Embryology, Wroclaw Medical University, Wroclaw, Poland
| | - Martyna Biala
- Department of Histology and Embryology, Wroclaw Medical University, Wroclaw, Poland
| | | | | | - Janusz Rys
- Department of Tumor Pathology, Maria Sklodowska-Curie Memorial Centre and Institute of Oncology, Cracow, Poland
| | | | - Piotr Dziegiel
- Department of Histology and Embryology, Wroclaw Medical University, Wroclaw, Poland.,Department of Human Biology, Department of Cosmetology, University School of Physical Education in Wroclaw, Wroclaw, Poland
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36
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Hou J, Wang H, Liu H, Guan H, Zhang Q, Qi W, Chen D, Shi C. Lymphangiosarcoma of the jejunum in a 44-year-old man: report of a case and review of literature. Int J Clin Exp Pathol 2017; 10:8751-8755. [PMID: 31966736 PMCID: PMC6965385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 05/27/2017] [Indexed: 06/10/2023]
Abstract
Lymphangiosarcoma is a malignant tumor arising from lymphatic endothelial cells and has largely been abandoned in the current classification of endothelial neoplasms. Recently, lymphangiosarcoma has been resurrected by several novel markers for lymphatic endothelium available for immunohistochemistry. Here, we reported a new case of lymphangiosarcoma that was located in the Jejunum of a 44-year-old man. To our best knowledge, this is the first report of lymphangiosarcoma in small intestine with no known history of lymphedema, lymphaticmalformation or previous radiation.
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Affiliation(s)
- Jinping Hou
- Department of Pathology, Dalian Medical University First HospitalDalian, Liaoning, China
| | - Huali Wang
- Department of Pathology, Dalian Medical University First HospitalDalian, Liaoning, China
| | - Haijing Liu
- Department of Pathology, Health Science Center of Peking UniversityBeijing, China
| | - Hongwei Guan
- Department of Pathology, Dalian Medical University First HospitalDalian, Liaoning, China
| | - Qiuping Zhang
- Department of Pathology, Dalian Medical University First HospitalDalian, Liaoning, China
| | - Wenjing Qi
- Department of Pathology, Dalian Medical University First HospitalDalian, Liaoning, China
| | - Dan Chen
- Department of Pathology, Dalian Medical University First HospitalDalian, Liaoning, China
| | - Chang Shi
- Department of Pathology, Dalian Medical University First HospitalDalian, Liaoning, China
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37
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Kong LL, Yang NZ, Shi LH, Zhao GH, Zhou W, Ding Q, Wang MH, Zhang YS. The optimum marker for the detection of lymphatic vessels. Mol Clin Oncol 2017; 7:515-520. [PMID: 28855985 PMCID: PMC5574200 DOI: 10.3892/mco.2017.1356] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 07/22/2017] [Indexed: 12/24/2022] Open
Abstract
Podoplanin, lymphatic vessel endothelial hyaluronic acid receptor-1, prospero-related homeobox-1 and vascular endothelial growth factor receptor 3 have been demonstrated to have crucial roles in the development of the lymphatic system and lymphangiogenesis process by combining with their corresponding receptors. Thus, the four markers have been widely used in labelling lymphatic vessels for the detection of lymphangiogenesis and lymphatic vessel invasion. Numerous authors have aimed to identify the roles of these four markers in the lymphatic system and the mechanisms have been partly clarified at the molecular level. The aim of the present review was to comprehensively clarify the characteristics and latent action modes of the four markers in order to determine which is the best one for the detection of lymphangiogenesis and lymphatic vessel invasion.
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Affiliation(s)
- Ling-Ling Kong
- Department of General Surgery, The First Affiliated Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241000, P.R. China
| | - Nian-Zhao Yang
- Department of General Surgery, The First Affiliated Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241000, P.R. China
| | - Liang-Hui Shi
- Department of General Surgery, The First Affiliated Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241000, P.R. China
| | - Guo-Hai Zhao
- Department of General Surgery, The First Affiliated Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241000, P.R. China
| | - Wenbin Zhou
- Department of General Surgery, The First Affiliated Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241000, P.R. China.,Department of Breast Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Qiang Ding
- Department of General Surgery, The First Affiliated Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241000, P.R. China.,Department of Breast Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Ming-Hai Wang
- Department of General Surgery, The First Affiliated Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241000, P.R. China
| | - Yi-Sheng Zhang
- Department of General Surgery, The First Affiliated Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241000, P.R. China
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38
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He C, Wang B, Wan C, Yang T, Shen Y. Diagnostic value of D2-40 immunostaining for malignant mesothelioma: a meta-analysis. Oncotarget 2017; 8:64407-64416. [PMID: 28969080 PMCID: PMC5610012 DOI: 10.18632/oncotarget.19041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/18/2017] [Indexed: 02/05/2023] Open
Abstract
Malignant mesothelioma (MM) has become a global disease burden for its rising incidence and invariable fatality. D2-40 has been widely used as an immunostaining marker of diagnosing MM, while its diagnostic value has not yet been evaluated. Our study aimed to assess the overall accuracy of D2-40 immunostaining for diagnosing MM through a meta-analysis. A total of 22 studies with 2,264 participants were identified from PubMed, EMBASE, Web of Science, Scopus and the Cochrane database. The pooled sensitivity and specificity of D2-40 for MM was 0.86 (95% CI: 0.84–0.89) and 0.77 (95% CI: 0.74–0.79), respectively. The area under the summary receiver operating characteristic curve is 0.93, with a diagnostic odds ratio 40.37 (95% CI: 19.97–81.61). None of the study variates was found to be a source of heterogeneity after meta-regression analysis. In conclusion, D2-40 immunostaining may not give sufficient evidence by itself to diagnose MM and should be in combination with other markers to improve the accuracy of diagnosis.
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Affiliation(s)
- Chao He
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Bo Wang
- Intensive Care Unit, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Chun Wan
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China
| | - Ting Yang
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China
| | - Yongchun Shen
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu 610041, China
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39
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Eroğlu A, Ersöz C, Karasoy D, Sak S. Vascular endothelial growth factor (VEGF)-C, VEGF-D, VEGFR-3 and D2-40 expressions in primary breast cancer: Association with lymph node metastasis. ADV CLIN EXP MED 2017; 26:245-249. [PMID: 28791841 DOI: 10.17219/acem/58784] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Two members of the vascular endothelial growth factor (VEGF) family, VEGF-C and -D, are known as lymphangiogenic growth factors and play an important role in tumor lymphangiogenesis via activation of the VEGF receptor (VEGFR)-3, which is expressed in lymphatic endothelial cells. D2-40 is a specific antibody for lymphatic vessel density (LVD). OBJECTIVES In the present study, we have aimed to evaluate whether intraand peri-tumoral D2-40-positive lymphatic vessels affect lymph node metastasis and to investigate the relationship between LVD and lymph node metastasis in breast cancer. MATERIAL AND METHODS We have evaluated the relationships between lymph node metastasis and VEGF-C, VEGF-D, VEGFR-3 and D2-40 expressions in breast cancer cells using immunohistochemistry. VEGF-C, VEGF-D and VEGFR-3 expression were found in tumor cells in the majority of the cases (83.75, 97.5 and 95%, respectively). RESULTS There was a significant positive relationship between VEGF-D expression and lymph node metastasis (p < 0.05) however no significant association was found in VEGF-C and VEGFR-3 expressions. It was found that patients with high-expression of VEGF-D have a high level of both periand intra-tumoral LVD compared to those with low expression of VEGF-D (p < 0.05). CONCLUSIONS Our results support that examination of VEGF-D expression in breast cancer cells may be beneficial in the identification of lymph node metastasis.
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Affiliation(s)
- Aydan Eroğlu
- Surgical Oncology Unit, Department of General Surgery, Ankara University Medical School, Ankara, Turkey
| | - Cevriye Ersöz
- Department of Pathology, Ankara University Medical School, Ankara, Turkey
| | - Durdu Karasoy
- Department of Statistics, Faculty of Science, Hacettepe University, Ankara, Turkey
| | - Serpil Sak
- Department of Pathology, Ankara University Medical School, Ankara, Turkey
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40
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Norhisham NF, Chong CY, Safuan S. Peritumoral lymphatic vessel density and invasion detected with immunohistochemical marker D240 is strongly associated with distant metastasis in breast carcinoma. BMC Clin Pathol 2017; 17:2. [PMID: 28203117 DOI: 10.1186/s12907-017-0041-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 01/30/2017] [Indexed: 12/25/2022] Open
Abstract
Background Detection of vascular invasion by hematoxylin and eosin staining is the current pathological assessment practice to diagnose breast carcinoma. However, conventional hematoxylin and eosin staining failed to distinguish between blood vessel invasion and lymphatic vessel invasion. Both are important prognostic criteria however with different outcomes. The aim of this study is to distinguish between blood vessel invasion and lymphatic vessel invasion using conventional assessment and immunohistochemical markers. The prognostic significance of both circulatory invasions in invasive breast carcinoma was also investigated. Methods Consecutive sections of breast carcinoma samples from 58 patients were stained with CD34 and D240 to stain blood and lymphatic vessels respectively. Hematoxylin and eosin staining was carried out on another consecutive section as conventional staining. Results Although blood vessel density is higher in the sections (median = 10.3 vessels) compared to lymphatic vessel density (median = 0.13), vessel invasion is predominantly lymphatic invasion (69.8 and 55.2% respectively). Interestingly, peritumoral lymphatic vessel density and peritumoral lymphatic invasion was significantly associated with distant metastasis (p = 0.049 and p = 0.05 respectively). The rate of false positive and false negative interpretation by hematoxylin and eosin was 46.7 and 53.3% respectively. Conclusions Lymphatic vessel invasion is a strong prognostic markers of breast carcinoma invasion and the use of immunohistochemical markers increase the rate and accuracy of detection.
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41
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Kitagawa Y, Ikebe D, Hara T, Kato K, Komatsu T, Kondo F, Azemoto R, Komoda F, Tanaka T, Saito H, Itami M, Yamaguchi T, Suzuki T. Enhanced detection of lymphovascular invasion in small rectal neuroendocrine tumors using D2-40 and Elastica van Gieson immunohistochemical analysis. Cancer Med 2016; 5:3121-3127. [PMID: 27748061 PMCID: PMC5119967 DOI: 10.1002/cam4.935] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 09/08/2016] [Accepted: 09/08/2016] [Indexed: 01/30/2023] Open
Abstract
Rectal neuroendocrine tumor (RNET) lymphovascular invasion (LVI) is regarded as an important predictor of nodal metastasis after endoscopic resection (ER). However, little is known about the frequency of immunohistochemical detection of LVI in RNETs. This study was performed to establish the actual detection of LVI rate in RNETs ≤10 mm and to evaluate associated clinical outcomes. We retrospectively reviewed the records for 98 consecutive patients treated by ER with a total of 102 RNETs ≤10 mm. Tissue sections were labeled with hematoxylin–eosin (HE) stain, the D2‐40 monoclonal antibody to evaluate lymphatic invasion, and Elastica van Gieson (EVG) stain to detect venous invasion. LVI detection rate by HE versus immunohistochemical analysis was compared. Follow‐up findings and clinical outcomes were also evaluated for 91 patients who were followed for ≥12 months. Lymphatic and venous invasion were detected using HE staining alone in 6.9% and 3.9% of patients, respectively, whereas they were detected using D2‐40 and EVG staining in 20.6% and 47.1% of the patients, respectively. Thus, the LVI detection frequency using D2‐40 and EVG staining (56.9%) was significantly higher than with HE (8.8%). Two out of seven patients who required additional surgery had regional lymph node metastases. However, among the 84 patients who were followed up without surgery, no distant metastases or recurrences were detected. Compared with HE staining, immunohistochemical analysis significantly increased the frequency of LVI detection in RNETs ≤10 mm. However, the clinical impact of LVIs detected using immunohistochemical analysis remains unclear. Clarification of the actual role of LVI using immunohistochemical analysis requires a patient long‐term follow‐up and outcomes.
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Affiliation(s)
| | - Dai Ikebe
- Division of Surgical Pathology, Chiba Cancer Center, Chiba, Japan
| | - Taro Hara
- Endoscopy Division, Chiba Cancer Center, Chiba, Japan
| | - Kazuki Kato
- Department of Gastroenterology, Funabashi Central Hospital, Funabashi, Japan
| | - Teisuke Komatsu
- Pathology Division, Funabashi Central Hospital, Funabashi, Japan
| | - Fukuo Kondo
- Pathology Division, School of Medicine, Teikyo University, Itabashi, Japan
| | - Ryousaku Azemoto
- Department of Gastroenterology, Kimitsu Chuo Hospital, Kimitsu, Japan
| | - Fumitake Komoda
- Department of Gastroenterology, Chiba Rosai Hospital, Ichihara, Japan
| | - Taketsugu Tanaka
- Department of Gastroenterology, Chiba Rosai Hospital, Ichihara, Japan
| | - Hirofumi Saito
- Department of Gastroenterology, Chiba Kaihin Municipal Hospital, Chiba, Japan
| | - Makiko Itami
- Division of Surgical Pathology, Chiba Cancer Center, Chiba, Japan
| | - Taketo Yamaguchi
- Department of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - Takuto Suzuki
- Endoscopy Division, Chiba Cancer Center, Chiba, Japan
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42
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Kelten Talu C, Boyaci C, Leblebici C, Hacihasanoglu E, Bozkurt ER. Pseudoangiomatous Stromal Hyperplasia in Core Needle Biopsies of Breast Specimens. Int J Surg Pathol 2016; 25:26-30. [PMID: 27450985 DOI: 10.1177/1066896916660763] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pseudoangiomatous stromal hyperplasia (PASH) is a benign lesion of myofibroblasts that is composed of a network of slit-like channels that resemble vascular spaces. The aims of this study were to document the frequency of PASH in core needle biopsy specimens (CNBS) of the breast, to describe which histopathologic findings coexist with PASH and to examine any endothelial cell differentiation. MATERIALS AND METHODS We reevaluated hematoxylin and eosin-stained sections of all CNBS that were obtained during a 1-year period. First, we performed CD34 and CD31 immunostainings to highlight the areas of PASH, then performed D2-40/podoplanin (lymphatic endothelial marker) and Fli-1 (vascular endothelial cell marker) immunostains. RESULTS The total number of CNBS was 412. Areas of PASH were noted in 37 of the 412 cases (9%), with a mean age of 38.5 years. The lesions that were described in association with PASH were "benign breast parenchyma with stromal fibrosis" (17/37; 46%), "fibroepithelial tumors" (17/37; 46%), "columnar cell changes (CCC)" (2/37; 5%), and "invasive carcinoma" (1/37; 3%). There were 2 cases of CCC within the foci of PASH (direct contact with PASH), and 8 additional cases of CCC that coexisted in the same specimen but were not in direct contact. There was no staining for D2-40 or Fli-1 within PASH foci. CONCLUSION PASH lesions occurred with a frequency of 9% in CNBS and were mostly in association with benign breast lesions in premenopausal women. CCC was determined as an accompanying epithelial lesion within or near PASH areas. No obvious immunopositivity compatible with endothelial cell differentiation was revealed.
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Affiliation(s)
- Canan Kelten Talu
- 1 Istanbul Research and Training Hospital, Pathology Department, Fatih, Istanbul, Turkey
| | - Ceren Boyaci
- 1 Istanbul Research and Training Hospital, Pathology Department, Fatih, Istanbul, Turkey
| | - Cem Leblebici
- 1 Istanbul Research and Training Hospital, Pathology Department, Fatih, Istanbul, Turkey
| | - Ezgi Hacihasanoglu
- 1 Istanbul Research and Training Hospital, Pathology Department, Fatih, Istanbul, Turkey
| | - Erol Rustu Bozkurt
- 1 Istanbul Research and Training Hospital, Pathology Department, Fatih, Istanbul, Turkey
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Abstract
OBJECTIVE pTNM stage IIA colorectal cancer (CRC) is not currently submitted to any adjuvant treatment due to its good prognosis. Nevertheless, a percentage of cases unexpectedly recur. The aim of this study was to assess and compare the prognostic value and inter-observer agreement of a novel histological grading system based on the counting of poorly differentiated clusters (PDC) of cancer cells and that of conventional histological grade, lymphatic, venous and perineural invasion (LVI, VI, PNI), tumour budding (TB) and tumor border configuration in stage IIA CRC. MATERIALS AND METHODS the afore mentioned histological parameters were assessed in 82 stage IIA CRCs. Inter-observer agreement and correlation with tumour relapse were analyzed by using Fleiss-Cohen's weighted K statistics, Fisher exact test and Chi-squared test. The Mantel-Cox log-rank test was applied to assess the strength of association with disease-free interval (DFI). RESULTS inter-observer agreement was very good/good in the assessment of PDC presence and grade, while it was moderate at best in the evaluation of the other parameters. The presence of PDC, high PDC grade, LVI and TB were significantly associated with disease progression (p < 0.0001; p = 0.0012; p = 0.0308; p = 0.0002) and shorter DFI (p = 0.0001; p < 0.0001; p = 0.0129; p = 0.0008). PDC presence (p < 0.0001) and TB (p = 0.012) were independent prognostic factors in multivariate analysis. CONCLUSIONS our findings suggest that the assessment of PDC may be useful to stratify patients with stage IIA CRC for recurrence risk, and to identify high risk patients who could benefit from adjuvant chemotherapy.
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Affiliation(s)
- Valeria Barresi
- a Department of Human Pathology "G. Barresi" , Unit of Anatomic Pathology, University of Messina , Italy and
| | - Luca Reggiani Bonetti
- b Department of Laboratory Integrated Activities , Anatomic Pathology and Legal Medicine, University of Modena and Reggio Emilia , Modena , Italy
| | - Antonio Ieni
- a Department of Human Pathology "G. Barresi" , Unit of Anatomic Pathology, University of Messina , Italy and
| | - Giovanni Branca
- a Department of Human Pathology "G. Barresi" , Unit of Anatomic Pathology, University of Messina , Italy and
| | - Giovanni Tuccari
- a Department of Human Pathology "G. Barresi" , Unit of Anatomic Pathology, University of Messina , Italy and
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Shareef MM, Radi DMA, Eid AMM. Tight junction protein claudin 4 in gastric carcinoma and its relation to lymphangiogenic activity. Arab J Gastroenterol 2015; 16:105-12. [PMID: 26526513 DOI: 10.1016/j.ajg.2015.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 08/25/2015] [Accepted: 09/28/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND STUDY AIMS Gastric cancer is the second most common cause of cancer-related death worldwide. Claudins are a family of tight junction proteins that are biologically relevant in many cancer progression steps. This study aimed to investigate the expression of the intestinal claudin (claudin 4) in gastric carcinoma and to evaluate its relation to the different clinicopathologic prognostic parameters, especially lymphangiogenesis (production of new lymphatic vessels, measured by lymphovascular density (LVD)) and lymphovascular invasion (LVI). PATIENTS AND METHODS Fifty-five gastric carcinoma specimens were immunohistochemically stained for claudin 4 and D2-40 (for detection of lymphatic vessel endothelium). RESULTS High expression of claudin 4 was detected in 26 of 55 (47.3%) cases. Low expression of claudin 4 was related to poorly differentiated type (p=0.001), non-intestinal (diffuse) type (p=0.001), deeper tumour invasion (p<0.001), lymph node metastasis (p=0.001), and higher stage (p=0.001). In addition, higher LVD was related to poorly differentiated types (p=0.001), non-intestinal type (p=0.001), lymph node metastasis (p=0.015), and higher tumour, node, metastasis (TNM) stage (p=0.001). LVI was related to lymph node metastasis (p=0.025), higher TNM stage (p=0.001), and LVD (p=0.001). Claudin 4 significantly correlated with both LVD (p=0.009) and LVI (p=0.009). CONCLUSIONS High expression of claudin 4 was associated with the more differentiated intestinal-type gastric carcinoma and lost in poorly differentiated diffuse type. So, claudin 4 may be used as one of the differentiating markers between the two major types of gastric carcinoma (intestinal vs. diffuse). LVD and LVI were related to higher incidence of lymph node metastasis and therefore could be used as predictive markers for lymph node metastasis in limited specimens during early gastric carcinoma to determine the need for more invasive surgery. Low expression of claudin 4 was related to lymphangiogenesis. This may shed light on the relation of tight junction protein expression and lymphangiogenesis.
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Radi DA, Abd-Elazeem MA. Prognostic Significance of Lymphatic Vessel Density Detected by D2-40 and Its Relation to Claudin-4 Expression in Prostatic Adenocarcinoma. Int J Surg Pathol 2015; 24:219-26. [PMID: 26464161 DOI: 10.1177/1066896915611488] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background Lymphovascular invasion is an important pathway of metastatic spread and regional lymph node metastasis is the major prognostic factor in prostatic adenocarcinoma. D2-40 is used to identify the lymphatic vessels and to assess the lymphatic vessel density (LVD). Expression of claudin-4 may be related to invasion and progression of carcinoma cells in several primary tumors. Aim To evaluate intra- and peritumoral LVD through immunohistochemical expression of D2-40 in relation to claudin-4 expression and clinicopathological parameters in prostatic adenocarcinoma. Materials and Methods Immunohistochemical staining procedure was performed on 53 paraffin-embedded blocks of radical prostatectomy specimens for prostatic adenocarcinoma using anti D2-40 and claudin-4 antibodies. Sections were evaluated for mean LVD in intratumoral and peritumoral tissues assessed by D2-40 expression. Results LVD in intratumoral tissues was significantly lower compared with peritumoral areas (P = .0001). Peritumoral mean LVD was significantly higher in cases with lymphovascular invasion (P = .041) and in cases with positive lymph node metastasis (P = .003) than intratumoral mean LVD. High claudin-4 expression was significantly correlated with high tumor grade (P = .0001), lymphovascular invasion (P = .006), and positive lymph node metastasis (P = .004). High claudin-4 expression was significantly associated with increased mean LVD in peritumoral tissues. Conclusion Increased peritumoral mean LVD in prostatic adenocarcinoma is associated with lymphovascular invasion and positive lymph node metastasis. High claudin-4 expression is associated with high tumor grade, lymphocascular invasion, positive lymph node metastasis, and high mean peritumoral LVD suggesting that D2-40 and claudin-4 may represent different mechanisms of lymphatic vessel invasion with both biomarkers is related to poor prognosis.
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Abstract
Eccrine angiomatous hamartoma is a rare hamartoma that usually affects childhood and adolescence. In this report we describe a typical onset and clinical presentation of eccrine angiomatous hamartoma. Histopathological analysis and immunohistochemical staining of the sections were done to confirm the diagnosis.
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Tajima S, Fukayama M. Possibility of D2-40 as a diagnostic and tumor differentiation-suggestive marker for some of phosphaturic mesenchymal tumors. Int J Clin Exp Pathol 2015; 8:9390-9396. [PMID: 26464693 PMCID: PMC4583925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 07/23/2015] [Indexed: 06/05/2023]
Abstract
Phosphaturic mesenchymal tumor (PMT) has been established as a tumor that causes tumor-induced osteomalacia (TIO) associated with mesenchymal neoplasm. Its lineage of differentiation has not been elucidated. Previously, the presence of lymphatic vessels inside PMTs has been documented using an anti-podoplanin antibody; the tumor cells of PMTs were reported to not react with it. In this study of 14 cases of PMTs, we used immunohistochemistry of D2-40, a relatively specific lymphatic endothelial marker, to see if they stained PMTs or not, with particular interest in its reaction with microcystic structures containing lymph-like fluid. We report that most of the PMTs (12 out of 14 cases; 86%) were immunostained by D2-40 in their tumor cells; D2-40-positive lymphatic vessels inside the tumor were also observed. We used a proportion score (0-4+), an intensity score (0-3+), and a total score (the sum of the proportion score and the intensity score) to quantitate our results. We report that 50% of cases (7 out of 14 cases) had a total score ≥ 4+; immunostaining of D2-40 in cases with a total score ≥ 4+ was easy to observe at a glance. Most of the tumor cells lining the microcystic structures were immunostained with D2-40. Thus, D2-40 could be a useful diagnostic marker of PMTs and it might also indicate that PMTs take a lymphatic endothelial immunophenotype.
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Affiliation(s)
- Shogo Tajima
- Department of Pathology, Graduate School of Medicine, The University of Tokyo Tokyo, Japan
| | - Masashi Fukayama
- Department of Pathology, Graduate School of Medicine, The University of Tokyo Tokyo, Japan
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Špirić Z, Erić M, Eri Ž, Skrobić M. Significantly high lymphatic vessel density in cutaneous metastasizing melanoma. Hippokratia 2015; 19:210-215. [PMID: 27418778 PMCID: PMC4938466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Cutaneous melanoma has the propensity to early metastatic spread via the lymphatic vessels. Recent studies have found a positive correlation between an increased number of tumor-associated lymphatics and lymph node metastasis. The aim of this study was to determine whether there was a difference in the lymphatic vessel density (LVD) when cutaneous metastasizing melanomas were compared with nonmetastasizing melanomas and nevi. METHODS Ninety-five melanoma specimens (45 with lymph node metastasis, 50 nonmetastasizing) and 22 nevi specimens (7 compound, 5 intradermal, 4 blue, and 6 dysplastic) were investigated by immunostaining for the lymphatic endothelial marker D2-40. The quantification of lymphatics was conducted by computer-assisted morphometric analysis. Metastasizing and nonmetastasizing melanoma specimens were matched according to their thickness into three classes ≤2.0 mm, 2.01 - 4.0 mm, >4.0 mm. RESULTS Metastasizing melanomas thick 2.01-4.0 mm and thicker than 4.0 mm, showed a significantly higher intratumoral and peritumoral LVD compared with nonmetastasizing melanomas (2.01-4.0 mm, p =0.006 and p =0.032, respectively; >4.0 mm, p =0.045 and p =0.026, respectively). No significant difference in intratumoral and peritumoral LVD was found between metastasizing and nonmetastasizing melanomas of thickness ≤2.0 mm. Metastasizing melanomas showed a significantly higher intratumoral LVD compared with compound, intradermal, blue and dysplastic nevi p <0.001, p =0.002, p =0.002 and p <0.001, respectively), and significantly higher peritumoral LVD compared with compound nevi (p=0.039). Total average LVD was significantly higher in metastasizing melanomas than in nonmetastasizing melanomas (p <0.001), compound, intradermal, blue and dysplastic nevi (p <0.001, p <0.001, p =0.001 and p <0.001, respectively). CONCLUSIONS This study shows higher LVD in metastasizing melanomas compared with nonmetastasizing melanomas and nevi. In melanomas with intermediate thickness and in thick melanomas, higher intratumoral and peritumoral LVD are significantly associated with lymph node metastasis. This finding suggests that LVD can be a useful marker for identifying melanomas which are at a higher risk for the metastasis development. Hippokratia 2015; 19 (3): 210-215.
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Affiliation(s)
- Z Špirić
- Department of Nuclear Medicine and Thyroid Diseases, Clinical Centre Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - M Erić
- Department of Anatomy, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Ž Eri
- Department of Pathology, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - M Skrobić
- Department of Nuclear Medicine, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
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Hurst NJ, Dominello M, Dyson G, Jaratli H, Sharma M, Ahmed YK, Melkane AE, Rose C, Jacobs J, Giorgadze T, Kim H. Intratumoral lymphatic vessel density as a predictor of progression-free and overall survival in locally advanced laryngeal/hypopharyngeal cancer. Head Neck 2015; 38 Suppl 1:E417-20. [PMID: 25641342 DOI: 10.1002/hed.24011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Lymphatic vessel density (LVD) has been shown to be an important predictor of survival in head and neck cancers. We report the predictive value of LVD for progression-free survival (PFS) and overall survival (OS) in laryngeal/hypopharyngeal cancer. METHODS Fifty-five untreated patients with T3/T4 laryngeal and T4 hypopharyngeal cancer underwent laryngectomy between 1999 and 2010. Surgical specimens were immunostained with D2-40, a specific lymphatic marker. LVDs were determined in tumor vessel "hot spots." Recursive partitioning analysis identified LVD thresholds for both peritumoral (LVDpt) and intratumoral (LVDit) vessels for association with PFS and OS. RESULTS Patients with mean LVDit of <11 vessels/mm(2) had 2-year PFS and OS rates of 58% and 65%, respectively, compared to 13% and 13% for those with LVDit ≥11 vessels/mm(2) (p = .06 and .04, respectively). CONCLUSION Intratumoral lymphatic vessel density is predictive of PFS and OS in locally advanced laryngeal/hypopharyngeal cancer. © 2015 Wiley Periodicals, Inc. Head Neck 38: E417-E420, 2016.
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Affiliation(s)
- Newton J Hurst
- Department of Radiation Oncology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Michael Dominello
- Department of Radiation Oncology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Gregory Dyson
- Department of Oncology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Hayan Jaratli
- Department of Pathology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Meenu Sharma
- Department of Pathology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Yasin K Ahmed
- Department of Pathology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Antoine E Melkane
- Department of Otolaryngology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Christopher Rose
- Department of Otolaryngology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - John Jacobs
- Department of Otolaryngology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Tamar Giorgadze
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Harold Kim
- Department of Radiation Oncology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
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Cabibi D, Giannone AG, Guarnotta C, Schillaci O, Franco V. D2-40 negative pyogenic granuloma-like Kaposi's sarcoma: Diagnostic features and histogenetic hypothesis of an uncommon skin tumor in HIV-negative patients. Pathol Res Pract 2015; 211:528-32. [PMID: 25939289 DOI: 10.1016/j.prp.2015.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 03/09/2015] [Accepted: 03/25/2015] [Indexed: 10/23/2022]
Abstract
Pyogenic granuloma-like Kaposi's sarcoma (PGLKS) is a recently described skin tumor showing features both of pyogenic granuloma (PG) and Kaposi's sarcoma (KS). The differential diagnosis is often challenging. We reviewed a series of 50 PG and 23 Ks located on distal extremities with the aid of an immunohistochemical panel comprising CD34, CD31, FVIII, SMA, D2-40, HHV8. After revision, 6/50 PG lesions previously diagnosed as PG, showed positive immunostaining for LNA1-HHV8 and focal positivity for CD31 and FVIII in the endothelial cells of the proliferating vessels, with some SMA positive pericytes. D2-40, a marker of lymphatic endothelium positive in KS, stained negatively. These lesions were renamed PGLKS. Of note, in our series, PGLKS represented the only form of KS localized in the hand; all the patients were HIV-negative, older than PG patients, with a prevalence for male gender. PGLKS and PG need a different management and a follow-up is advisable for PGLKS, as for the other variants of KS. To date, D2-40 negative immunostaining has not yet been reported in PGLKS and should not lead to a misdiagnosis of PG. The morphological similarities with PG and the immunohistochemical findings, showing a defective phenotype of the neoplastic cells, suggest a histogenetic hypothesis in which D2-40 negative PGLKS could represent an early stage of HHV8 infection of a pre-existing PG, whose vessels loose progressively their blood vascular markers but have not still acquired the lymphatic ones.
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Affiliation(s)
- D Cabibi
- Anatomic Pathology, Department of Sciences for Promotion of Health and Mother and Child Care, University of Palermo, Palermo, Italy
| | - A G Giannone
- Anatomic Pathology, Department of Sciences for Promotion of Health and Mother and Child Care, University of Palermo, Palermo, Italy.
| | - C Guarnotta
- Anatomic Pathology, Department of Sciences for Promotion of Health and Mother and Child Care, University of Palermo, Palermo, Italy
| | - O Schillaci
- Servizio di Anatomia Patologica, Dipartimento Oncologico di III livello, La Maddalena Casa di Cura di Alta Specialità, Palermo, Italy
| | - V Franco
- Anatomic Pathology, Department of Sciences for Promotion of Health and Mother and Child Care, University of Palermo, Palermo, Italy
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