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Difference between revisions of "Lymphovascular invasion"
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[[Image:Laryngeal squamous carcinoma - LVI -- very high mag.jpg|thumb|right|Lymphovascular invasion in a case of [[laryngeal cancer]]. [[H&E stain]].]] | |||
'''Lymphovascular invasion''', also '''lymphovascular space invasion''', is (non-hematologic) malignant cells within [[blood vessels]] and/or lymphatics. It is abbreviated '''LVI'''. | '''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]]. | 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== | ==General== | ||
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**Exceptions: | **Exceptions: | ||
***[[Seminoma]]. | ***[[Seminoma]]. | ||
***[[Squamous cell carcinoma of the penis]]. | |||
***Intrahepatic bile duct carcinoma ([[cholangiocarcinoma]]).<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2012/IntrahepBileDucts_12protocol_3101.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2012/IntrahepBileDucts_12protocol_3101.pdf]. Accessed on: 23 May 2013.</ref> | ***Intrahepatic bile duct carcinoma ([[cholangiocarcinoma]]).<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2012/IntrahepBileDucts_12protocol_3101.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2012/IntrahepBileDucts_12protocol_3101.pdf]. Accessed on: 23 May 2013.</ref> | ||
***[[Hepatocellular carcinoma]].<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/Hepatocellular_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/Hepatocellular_11protocol.pdf]. Accessed on: 6 April 2012.</ref> | ***[[Hepatocellular carcinoma]].<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/Hepatocellular_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/Hepatocellular_11protocol.pdf]. Accessed on: 6 April 2012.</ref> | ||
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|- | |- | ||
| [[Urothelial carcinoma]] | | [[Urothelial carcinoma]] | ||
| independent predictor of a poor prognosis | | independent predictor of a poor prognosis in bladder tumours | ||
| LVI has more predictive power than [[tumour stage]]<ref name=pmid19494855>{{Cite journal | last1 = Cheng | first1 = L. | last2 = Montironi | first2 = R. | last3 = Davidson | first3 = DD. | last4 = Lopez-Beltran | first4 = A. | title = Staging and reporting of urothelial carcinoma of the urinary bladder. | journal = Mod Pathol | volume = 22 Suppl 2 | issue = | pages = S70-95 | month = Jun | year = 2009 | doi = 10.1038/modpathol.2009.1 | PMID = 19494855 | URL = http://www.nature.com/modpathol/journal/v22/n2s/full/modpathol20091a.html }}</ref> | | LVI has more predictive power than [[tumour stage]] in the [[urinary bladder]];<ref name=pmid19494855>{{Cite journal | last1 = Cheng | first1 = L. | last2 = Montironi | first2 = R. | last3 = Davidson | first3 = DD. | last4 = Lopez-Beltran | first4 = A. | title = Staging and reporting of urothelial carcinoma of the urinary bladder. | journal = Mod Pathol | volume = 22 Suppl 2 | issue = | pages = S70-95 | month = Jun | year = 2009 | doi = 10.1038/modpathol.2009.1 | PMID = 19494855 | URL = http://www.nature.com/modpathol/journal/v22/n2s/full/modpathol20091a.html }}</ref> appears to be less important in upper urinary tract disease<ref name=pmid24954108>{{Cite journal | last1 = Kim | first1 = HS. | last2 = Kim | first2 = M. | last3 = Jeong | first3 = CW. | last4 = Kwak | first4 = C. | last5 = Kim | first5 = HH. | last6 = Ku | first6 = JH. | title = Presence of lymphovascular invasion in urothelial bladder cancer specimens after transurethral resections correlates with risk of upstaging and survival: A systematic review and meta-analysis. | journal = Urol Oncol | volume = | issue = | pages = | month = Jun | year = 2014 | doi = 10.1016/j.urolonc.2014.05.008 | PMID = 24954108 }}</ref> | ||
|- | |- | ||
| [[Breast cancer]] | | [[Breast cancer]] | ||
| Line 30: | Line 32: | ||
| [[Colorectal carcinoma]] | | [[Colorectal carcinoma]] | ||
| independent predictor of poorer prognosis (sporadic cancers)<ref name=pmid20305435>{{Cite journal | last1 = Lim | first1 = SB. | last2 = Yu | first2 = CS. | last3 = Jang | first3 = SJ. | last4 = Kim | first4 = TW. | last5 = Kim | first5 = JH. | last6 = Kim | first6 = JC. | title = Prognostic significance of lymphovascular invasion in sporadic colorectal cancer. | journal = Dis Colon Rectum | volume = 53 | issue = 4 | pages = 377-84 | month = Apr | year = 2010 | doi = 10.1007/DCR.0b013e3181cf8ae5 | PMID = 20305435 }}</ref> | | independent predictor of poorer prognosis (sporadic cancers)<ref name=pmid20305435>{{Cite journal | last1 = Lim | first1 = SB. | last2 = Yu | first2 = CS. | last3 = Jang | first3 = SJ. | last4 = Kim | first4 = TW. | last5 = Kim | first5 = JH. | last6 = Kim | first6 = JC. | title = Prognostic significance of lymphovascular invasion in sporadic colorectal cancer. | journal = Dis Colon Rectum | volume = 53 | issue = 4 | pages = 377-84 | month = Apr | year = 2010 | doi = 10.1007/DCR.0b013e3181cf8ae5 | PMID = 20305435 }}</ref> | ||
| may be used as a [[quality]] measure; 25% of cases should have vascular invasion<ref>{{Cite journal | last1 = Messenger | first1 = DE. | last2 = Driman | first2 = DK. | last3 = Riddell | first3 = R. | last4 = McLeod | first4 = R. | last5 = Kirsch | first5 = R. | title =Is Venous Invasion in Colorectal Cancer an Under-Reported Finding | | may be used as a [[quality]] measure; 25% of cases should have vascular invasion<ref>{{Cite journal | last1 = Messenger | first1 = DE. | last2 = Driman | first2 = DK. | last3 = Riddell | first3 = R. | last4 = McLeod | first4 = R. | last5 = Kirsch | first5 = R. | title = Is Venous Invasion in Colorectal Cancer an Under-Reported Finding | ||
among Canadian Pathologists? Results of a Population-Based Survey | among Canadian Pathologists? Results of a Population-Based Survey | ||
of Ontario Pathologists. | journal = Can J Pathol | volume = 2 | issue = 4 | pages = 46-9 | month = | year = 2012 | doi = | PMID = | url = http://www. | of Ontario Pathologists. | journal = Can J Pathol | volume = 2 | issue = 4 | pages = 46-9 | month = | year = 2012 | doi = | PMID = | url = http://www.allegrahamilton.com/publications/ajp/cjp/p4_2/ }} </ref> | ||
|- | |- | ||
|} | |} | ||
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<gallery> | <gallery> | ||
Image:Merkel_cell_carcinoma_-_high_mag.jpg | Small focus of LVI in a [[merkel cell carcinoma]]. (WC/Nephron) | Image:Merkel_cell_carcinoma_-_high_mag.jpg | Small focus of LVI in a [[merkel cell carcinoma]]. (WC/Nephron) | ||
Image: | Image: Seminoma LVI -- low mag.jpg | [[LVI]] - low mag. (WC/Nephron) | ||
Image: Seminoma LVI -- intermed mag.jpg | LVI - intermed. mag. (WC/Nephron) | |||
</gallery> | |||
<gallery> | |||
Image: CRC with LVI - HE -- very low mag.jpg | [[colorectal carcinoma|CRC]] with LVI - very low mag. (WC/Nephron) | |||
Image: CRC with LVI - HE -- low mag.jpg | CRC with LVI - low mag. (WC/Nephron) | |||
Image: CRC with LVI - HE -- intermed mag.jpg | CRC with LVI - intermed. mag. (WC/Nephron) | |||
Image: CRC with LVI - HE - alt -- high mag.jpg | CRC with LVI - high mag. (WC/Nephron) | |||
Image: CRC with LVI - HE -- very high mag.jpg | CRC with LVI - very high mag. (WC/Nephron) | |||
</gallery> | </gallery> | ||
==Stains== | ==Stains== | ||
*[[Movat stain]] - especially useful in [[colorectal carcinoma]] so one can readily identify [[blood vessel]]s.<ref name=pmid19861561>{{Cite journal | last1 = Howlett | first1 = CJ. | last2 = Tweedie | first2 = EJ. | last3 = Driman | first3 = DK. | title = Use of an elastic stain to show venous invasion in colorectal carcinoma: a simple technique for detection of an important prognostic factor. | journal = J Clin Pathol | volume = 62 | issue = 11 | pages = 1021-5 | month = Nov | year = 2009 | doi = 10.1136/jcp.2009.065615 | PMID = 19861561 }}</ref> | *[[Movat stain]] - especially useful in [[colorectal carcinoma]] so one can readily identify [[blood vessel]]s.<ref name=pmid19861561>{{Cite journal | last1 = Howlett | first1 = CJ. | last2 = Tweedie | first2 = EJ. | last3 = Driman | first3 = DK. | title = Use of an elastic stain to show venous invasion in colorectal carcinoma: a simple technique for detection of an important prognostic factor. | journal = J Clin Pathol | volume = 62 | issue = 11 | pages = 1021-5 | month = Nov | year = 2009 | doi = 10.1136/jcp.2009.065615 | PMID = 19861561 }}</ref> | ||
*[[ | *Elastin stain. | ||
===Images=== | |||
<gallery> | |||
Image: CRC with LVI - elastin -- very low mag.jpg | [[colorectal carcinoma|CRC]] with LVI - elastin - very low mag. (WC/Nephron) | |||
Image: CRC with LVI - elastin -- low mag.jpg | CRC with LVI - elastin - low mag. (WC/Nephron) | |||
Image: CRC with LVI - elastin -- intermed mag.jpg | CRC with LVI - elastin - intermed. mag. (WC/Nephron) | |||
Image: CRC with LVI - elastin - alt -- high mag.jpg | CRC with LVI - elastin - high mag. (WC/Nephron) | |||
Image: CRC with LVI - elastin -- very high mag.jpg | CRC with LVI - elastin - very high mag. (WC/Nephron) | |||
</gallery> | |||
==IHC== | ==IHC== | ||
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Markers with high specific to lymphatic spaces: | Markers with high specific to lymphatic spaces: | ||
*D2-40. | *[[D2-40]]. | ||
==See also== | ==See also== | ||
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*[[Intravascular lymphoma]]. | *[[Intravascular lymphoma]]. | ||
*[[Perineural invasion]]. | *[[Perineural invasion]]. | ||
*[[Angioinvasion]]. | |||
*[[MELF]]. | |||
==References== | ==References== | ||