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Intratumoural lymphatics in benign and malignant soft tissue tumours

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Abstract

Soft tissue sarcomas do not generally metastasise via lymphatics, and the presence or absence of lymphatic vessels within sarcomas and benign soft tissue tumours is not known. In this study, we determined whether lymphatic vessels were present in a wide range of benign and malignant soft tissue lesions by examining intratumoural expression of the lymphatic endothelial cell markers, Lyve-1 and podoplanin. Intratumoural Lyve-1+/podoplanin+ lymphatics were not identified in sarcomas apart from all cases of epithelioid sarcoma (a tumour which is known to metastasise to lymph nodes) and a few cases of leiomyosarcoma, rhabdomyosarcoma and synovial sarcoma. Intratumoural lymphatics were also absent in most benign soft tissue tumours. Reparative and inflammatory soft tissue lesions contained lymphatics, as did all (pseudosarcomatous) proliferative myofibroblastic lesions including nodular, proliferative and ischaemic fasciitis, elastofibroma, nuchal fibroma and deep fibromatosis. Our results show that most soft tissue sarcomas do not contain intratumoural lymphatics, a finding which is consistent with the infrequent finding of sarcoma metastasis to lymph nodes. In contrast to fibrosarcoma and a number of other malignant spindle cell tumours, proliferative fibroblastic/myofibroblastic lesions of soft tissue contain intralesional lymphatic vessels.

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References

  1. Sondak VK, Chang AE (2001) Clinical evaluation and treatment of soft tissue tumours. In: Weiss SW, Goldblum JR (eds) Enzinger and Weiss’s soft tissue tumours. 4th edn. Mosby, St. Louis, pp 21–44

    Google Scholar 

  2. Fong Y, Coit DG, Woodruff JM et al (1993) Lymph node metastasis from soft tissue sarcoma in adults. Analysis of data from a prospective database of 1772 sarcoma patients. Ann Surg 217:72–77

    Article  PubMed  CAS  Google Scholar 

  3. Behranwala KA, A’Hern R, Omar A et al (2004) Prognosis of lymph node metastasis in soft tissue sarcoma. Ann Surg Oncol 11:714–719

    Article  PubMed  Google Scholar 

  4. Weingrad DN, Rosenburg SA (1978) Early lymphatic spread of osteogenic and soft-tissue sarcomas. Surgery 84:231–240

    PubMed  CAS  Google Scholar 

  5. Williams CSM, Leek RD, Robson AM et al (2003) Absence of lymphangiogenesis and intratumoral lymph vessels in human metastatic breast cancer. J Pathol 200:195–206

    Article  PubMed  CAS  Google Scholar 

  6. Bono P, Wasenius V, Heikkilä P et al (2004) High Lyve-1 positive lymphatic vessels are associated with poor outcome in breast cancer. Clin Cancer Res 10:7144–7149

    Article  PubMed  CAS  Google Scholar 

  7. Hosking B, Makinen T (2007) Lymphatic vasculature: a molecular perspective. Bioessays 29:1192–1202

    Article  PubMed  CAS  Google Scholar 

  8. Ji RC (2005) Characteristics of lymphatic endothelial cells in physiological and pathological conditions. Histol Histopathol 20:155–175

    PubMed  CAS  Google Scholar 

  9. Schledzewski K, Falkowski M, Moldenhauer G et al (2006) Lymphatic endothelium-specific hyaluronan receptor LYVE-1 is expressed by stabilin-1+, F4/80+, CD11b+ macrophages in malignant tumours and wound healing tissue in vivo and in bone marrow cultures in vitro: implication for the assessment of lymphangiogenesis. J Pathol 209:67–77

    Article  PubMed  CAS  Google Scholar 

  10. Montgomery EA, Meis JM (1991) Nodular fasciitis; its morphological spectrum and immunohistochemical profile. Am J Surg Pathol 15:942–948

    Article  PubMed  CAS  Google Scholar 

  11. Soule EH, Minn R (1975) Proliferative (nodular) fasciitis. Arch Pathol 73:17–24

    Google Scholar 

  12. Akerman M (1997) Benign fibrous lesions masquerading as sarcomas; clinical and morphological pitfalls. Acta Orthop Scand 68:37–40

    Google Scholar 

  13. Kim ST, Kim HJ, Park SW et al (2005) Nodular fasciitis in the head and neck: CT and MR imaging findings. Am J Neuroradiol 26:2617–2623

    PubMed  Google Scholar 

  14. Pritchard DJ, Nascimento AG, Petersen IA (1996) Local control of extra-abdominal desmoid tumors. J Bone Joint Surg 78A:848–854

    Google Scholar 

  15. Lopez R, Kemalyan N, Moseley HS et al (1990) Problems in diagnosis and management of desmoid tumors. Am J Surg 159:450–453

    Article  PubMed  CAS  Google Scholar 

  16. De Wever I, Cin PD, Fletcher CDM et al (2000) Cytogenetics, clinical and morphological correlation in 78 cases of fibromatosis: a report from the CHAMP study group. Mod Pathol 13:1080–1085

    Article  PubMed  Google Scholar 

  17. Breiteneder-Geleff S, Soleiman A, Kowalski H et al (1999) Angiosarcomas express mixed endothelial phenotypes of blood and lymphatic capillaries: podoplanin as a specific marker for lymphatic endothelium. Am J Pathol 154:385–394

    PubMed  CAS  Google Scholar 

  18. Banerji S, Ni J, Wang S et al (1999) LYVE-1, a new homologue of the CD44 glycoprotein, is a lymph-specific receptor for hyaluronan. J Cell Biol 144:789–801

    Article  PubMed  CAS  Google Scholar 

  19. Fletcher CDM, Unni KK, Mertens F (eds) (2002) World Health Organisation classification of tumours. pathology and genetics of tumours of soft tissue and bone. IARC, Lyon

  20. Ordóñez NG (2005) D2-40 and podoplanin are highly specific and sensitive immunohistochemical markers of epithelioid malignant mesothelioma. Hum Pathol 36:372–380

    Article  PubMed  CAS  Google Scholar 

  21. De Visscher SAHJ, Ginkel RJV, Wobbes T et al (2006) Epithelioid sarcoma: still an only surgically curable disease. Cancer 107:606–612

    Article  PubMed  Google Scholar 

  22. Chase DR, Enzinger FM (1985) Epithelioid sarcoma: diagnosis, prognostic indicators and treatment. Am J Surg Pathol 9:241–263

    Article  PubMed  CAS  Google Scholar 

  23. Baratti D, Pennacchioli E, Casali PG et al (2007) Epithelioid sarcoma: prognostic factors and survival in a series of patients treated at a single institution. Ann Surg Oncol 12:3542–3551

    Article  Google Scholar 

  24. Friedrichs N, Hahne JC, Pepper MS et al (2006) Immunohistochemical quantification of lymph vessels, VEGF-C and VEGF receptor 3 in human sarcomas. Histopathology 49:87–88

    Article  PubMed  CAS  Google Scholar 

  25. Beasley NJ, Prevo R, Banerji S et al (2002) Intratumoral lymphangiogenesis and lymph node metastasis in head and neck cancer. Cancer Res 62:1315–1320

    PubMed  CAS  Google Scholar 

  26. Stacker SA, Baldwin ME, Achen MG et al (2002) The role of tumour lymphangiogenesis in metastatic spread. FASEB J 16:922–934

    Article  PubMed  CAS  Google Scholar 

  27. Pepper MS, Skobe M (2003) Lymphatic endothelium: morphological, molecular and functional properties. J Cell Biol 163:209–213

    Article  PubMed  CAS  Google Scholar 

  28. Padera TM, Kadambi A, di Tomaso E et al (2002) Lymphatic metastasis in the absence of functional intratumoural lymphatics. Science 296:1883–1886

    Article  PubMed  CAS  Google Scholar 

  29. Leu AJ, Berk DA, Lymboussaki A et al (2000) Absence of functional lymphatics within a murine sarcoma: a molecular and functional evaluation. Cancer Res 60:4324–4327

    PubMed  CAS  Google Scholar 

  30. Jain RK, Fenton BT (2002) Intratumoral lymphatic vessels: a case of mistaken identity or malfunction? J Natl Cancer Inst 94:417–421

    PubMed  Google Scholar 

  31. Maula SM, Luukkaa M, Grénman R et al (2003) Intratumoral lymphatics are essential for the metastatic spread and prognosis in squamous cell carcinoma of the head and neck region. Cancer Res 63:1920–1926

    PubMed  CAS  Google Scholar 

  32. Dadras SS, Paul T, Bertoncini J et al (2003) Tumor lymphangiogenesis: a novel prognostic indicator for cutaneous melanoma metastasis and survival. Am J Pathol 162:1951–1960

    PubMed  Google Scholar 

  33. Hall FT, Freeman JL, Jackson DG et al (2003) Intratumoral lymphatics and lymph node metastasis in papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg 129:716–719

    Article  PubMed  Google Scholar 

  34. Cursiefen C, Chen L, Borges LP et al (2004) VEGF-A stimulates lymphangiogenesis and hemangiogenesis in inflammatory neovascularization via macrophage recruitment. J Clin Invest 113:1040–1050

    PubMed  CAS  Google Scholar 

  35. Weiss SW, Goldblum JR (2001) Fibromatosis. In: Weiss SW, Goldblum JR (eds) Enzinger and Weiss’s soft tissue tumours. 4th edn. Mosby, St. Louis, pp 309–346

    Google Scholar 

  36. Weiss SW, Goldblum JR (2001) Benign fibrous tissue lesions. In: Weiss SW, Goldblum JR (eds) Enzinger and Weiss’s soft tissue tumours. 4th edn. Mosby, St. Louis, pp 247–307

    Google Scholar 

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Acknowledgements

The authors thank Mrs. C. Lowe for typing the manuscript. Dr. Mahendra was a Visiting Fellow funded by the government of Sri Lanka.

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We declare that we have no conflict of interest.

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Correspondence to N. A. Athanasou.

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Mahendra, G., Kliskey, K., Williams, K. et al. Intratumoural lymphatics in benign and malignant soft tissue tumours. Virchows Arch 453, 457–464 (2008). https://doi.org/10.1007/s00428-008-0660-3

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  • DOI: https://doi.org/10.1007/s00428-008-0660-3

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