Lymphatic vascular density and lymphangiogenesis during tumour progression of carcinoma ex pleomorphic adenoma

• Published in: Journal of clinical pathology 2007-09, Vol.60 (9), p.995-1000
• Main Authors: Soares, A B, Ponchio, L, Juliano, P B, de Araújo, V C, Altemani, A
• Format: Article
• Language: English
• Subjects: Adenoma, Pleomorphic - metabolism; Adenoma, Pleomorphic - pathology; Aged; Antibodies, Monoclonal - metabolism; Antibodies, Monoclonal, Murine-Derived; Antigens; Biological and medical sciences; Biomarkers, Tumor - metabolism; carcinoma ex pleomorphic adenoma; Colleges & universities; CXPA; Disease Progression; Humans; Immunoenzyme Techniques; Immunoglobulins; Investigative techniques, diagnostic techniques (general aspects); Ki-67 Antigen - metabolism; LVD; lymph vessel; Lymphangiogenesis; lymphatic vascular density; Lymphatic Vessels - pathology; Medical sciences; Melanoma; Metastasis; Middle Aged; Neoplasm Invasiveness; Original; Otorhinolaryngology. Stomatology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; pleomorphic adenoma; Salivary Gland Neoplasms - metabolism; Salivary Gland Neoplasms - pathology; Salivary Glands - anatomy & histology; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 0021-9746; 1472-4146
• DOI: 10.1136/jcp.2006.042523

Aims: To assess lymphatic vascular density (LVD) and lymph vessel endothelial proliferation in a series of carcinoma ex pleomorphic adenoma (CXPA) that represents the tumour in the different carcinogenesis phases and tumour progression. Methods: In 8 cases of early CXPA (intracapsular and minimally invasive tumours), 8 of advanced CXPA (widely invasive tumours) and 10 of pleomorphic adenoma (PA) without malignant transformation, lymphatic vessels and proliferating cells were detected using the antibodies D2-40 and Ki-67 respectively. Results: Comparing early tumours with advanced ones, LVD was not significantly different at the tumour margin. In contrast, regarding intratumoural lymphatics, PA without malignant transformation and early CXPA contained rare, if any, lymph vessels, whereas in widely invasive carcinomas they were more numerous. However, neither intratumoural nor peritumoural LVD were increased in comparison to adjacent normal salivary gland tissue. In no case did dual immunohistochemistry using D2-40 and the cell proliferation marker Ki-67 reveal the existence of proliferating lymphatics. Carcinomatous emboli were found in peritumoural as well as in intratumoural lymphatics only in advanced CXPA without myoepithelial differentiation. Conclusion: In CXPA, the lymphatic network is mainly composed of pre-existing lymphatics which are rare in tumours that have not infiltrated outside the confines of the original PA. In the widely invasive CXPA, intratumoural as well as peritumoural lymphatics are a conduit for carcinoma cells, but in carcinomas with myoepithelial differentiation, the neoplastic cells seem to have a lower invasion capacity.