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Cite this page: Prognostic factors - Angiolymphatic invasion. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/breastmalignantprognosisangiolymphatic.html. Accessed July 14th, 2017.
Definition / general
- Prognostic significance particularly for lymphatic invasion (Am J Surg Pathol 2007;31:1825, Am J Surg Pathol 1977;1:25) and D2-40 microvessel density (Am J Clin Pathol 2008;129:578)
- Note that D2-40 is not specific for lymphatic endothelium because it also stains breast myoepithelium (Hum Pathol 2008;39:175, Appl Immunohistochem Mol Morphol 2009;17:425)
- Lymphatic invasion occurs primarily at invasive front of tumor
- Related variables - presence of 6+ apoptotic figures in tumor emboli in patients without nodal metastases and 4+ mitotic figures in tumor emboli of patients with nodal metastases (Mod Pathol 2002;15:904, Hum Pathol 2008;39:427)
- Lymph vessel tumor emboli in stroma invasive tumor area (by H&E or D2-40) predicts high risk of tumor recurrence or death (Hum Pathol 2007;38:247, Mod Pathol 2007;20:183)
- Lymphatic invasion may be particularly important in node negative patients (Ann Oncol 2007;18:1632)
- Although they should be distinguished, lymphatic invasion is associated with extensive retraction artifact (Am J Surg Pathol 2007;31:129)
- Correlates with more positive lymph nodes (sentinel and non-sentinel) and size of largest metastatic deposits (Am Surg 2011;77:874)
Microscopic (histologic) images
Images hosted on PathOut servers:
Not angiolymphatic invasion, but shrinkage
artifact with partly necrotic tumor in space created
by shrinkage; no endothelial cells are present, elastic
stain highlights elastic tissue in walls of vessels (AFIP)
Images hosted on Flickr:
Tumor in vessel wall (left), post-chemotherapy (right), courtesy of Dr. Semir Vranic
Images hosted on Nature servers:
Various images
Blood vessel versus
lymphatic vascular invasion
D2-40 stains endothelium of lymphatic but not artery or vein
D2-40+ lymphatics without tumor emboli at advancing front of tumor
D2-40+ lymphatics containing tumor emboli
Tumor emboli within tumor
Images hosted on other servers:
Various images
Cuff of lymphatic invasion around a small vein in a vascular bundle
CD31 and D2-40
Not angiolymphatic invasion
Retraction artifact
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