Difference between revisions of "Lymphovascular invasion"
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==General== | ==General== | ||
*LVI, in the TNM staging system, does '''not''' affect tumour stage; however, there are exceptions. | |||
**Exceptions: | |||
Exceptions: | ***[[Seminoma]]. | ||
*[[Seminoma]]. | *LVI generally = poorer prognosis.<ref name=pmid10101593>{{Cite journal | last1 = Moreira | first1 = LF. | last2 = Kenmotsu | first2 = M. | last3 = Gochi | first3 = A. | last4 = Tanaka | first4 = N. | last5 = Orita | first5 = K. | title = Lymphovascular and neural invasion in low-lying rectal carcinoma. | journal = Cancer Detect Prev | volume = 23 | issue = 2 | pages = 123-8 | month = | year = 1999 | doi = | PMID = 10101593 }}</ref> | ||
==Microscopic== | ==Microscopic== | ||
Revision as of 03:54, 28 March 2012
Lymphovascular invasion, also lymphovascular space invasion, is (non-hematologic) malignant cells within blood vessels and/or lymphatics. It is abbreviated LVI.
The term lymphovascular invasion is preferred to vascular invasion, as it is very difficult to differentiate morphologically small lymphatics and small vascular spaces, without immunohistochemistry.
General
- LVI, in the TNM staging system, does not affect tumour stage; however, there are exceptions.
- Exceptions:
- LVI generally = poorer prognosis.[1]
Microscopic
Rosen criteria for LVI (in the breast):[2][3]
- Must be outside of the tumour proper.
- LVI is usually very close -- typically within 0.1 cm.
- Contour of cells should differ from possible vessel wall.
- DCIS with retraction artifact mimicing LVI has a contour that matches its surrounding fibrous tissue.
- Endothelium (usu. flat) should be visible.
- Lymphatics are found adjacent to blood vessels - vessels should be present in the vicinity.
Memory device LUBE-O:
- LVI has a Unique contour, Blood vessels and Endothelium in the vicinity, and is Outside of the tumour.
Notes:
- Criteria for LVI vary by the site/tumour.
- In some sites, the first criterium (tumour cells outside of the tumour proper) isn't required.
Stains
- Movat stain - especially useful in colorectal carcinoma so one can readily identify blood vessels.[4]
IHC
Vascular markers:
- CD31.
- CD34.
Markers with high specific to lymphatic spaces:
- D2-40.
See also
References
- ↑ Moreira, LF.; Kenmotsu, M.; Gochi, A.; Tanaka, N.; Orita, K. (1999). "Lymphovascular and neural invasion in low-lying rectal carcinoma.". Cancer Detect Prev 23 (2): 123-8. PMID 10101593.
- ↑ Rosen, PP. (1983). "Tumor emboli in intramammary lymphatics in breast carcinoma: pathologic criteria for diagnosis and clinical significance.". Pathol Annu 18 Pt 2: 215-32. PMID 6674861.
- ↑ URL: http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2009/InvasiveBreast_09protocol.pdf. Accessed on: 5 August 2011.
- ↑ Howlett, CJ.; Tweedie, EJ.; Driman, DK. (Nov 2009). "Use of an elastic stain to show venous invasion in colorectal carcinoma: a simple technique for detection of an important prognostic factor.". J Clin Pathol 62 (11): 1021-5. doi:10.1136/jcp.2009.065615. PMID 19861561.