ABSTRACT
AIMS: Angiogenesis is essential for the growth of solid tumours. As the role of angiogenesis is unclear in the pathogenesis of primary lymph node (LN) tumours, we wondered whether neoangiogenesis was important in supporting and promoting the growth of tumours in LNs. METHODS AND RESULTS: We investigated 16 cases of squamous carcinoma involving oral cavity (n=9) and larynx/pyriform fossa (n=7), all of whom had lymph node metastases. Sections of the primary tumour, uninvolved mucosa, metastatic LN and nonmetastatic LN were double-immunostained with factor VIII-related antigen and MIB-1. Proliferating blood vessels, i.e. neoangiogenesis, was identified by coexpression of factor VIII-related antigen-stained blood vessels and MIB-1 staining of the endothelial cell nuclei. Counts were performed in an area of 4 mm2. Primary tumours (127-188.7), uninvolved mucosa (54-84.5) and metastatic LNs (123.5-167) had significantly lower vessel counts than nonmetastatic LNs (194-253.9) (P=0.003; P < 0.001; P < 0.001, respectively). With regard to neoangiogenesis, primary tumours (1.7-5) had significantly higher counts than uninvolved mucosa (0-0.4), nonmetastatic LNs (0-0.4) and metastatic LNs (0.9-2.4) (P < 0.001; P < 0.001; P=0.047, respectively). CONCLUSIONS: Our data suggest that because of the rich native vascularity of lymph nodes, neoangiogenesis is redundant for the growth of metastatic tumour.
Subject(s)
Carcinoma, Squamous Cell/pathology , Head and Neck Neoplasms/pathology , Lymphatic Metastasis/pathology , Neovascularization, Pathologic , Blood Vessels/chemistry , Blood Vessels/pathology , Humans , Immunohistochemistry , Ki-67 Antigen/analysis , Lymph Nodes/blood supply , Lymph Nodes/pathology , von Willebrand Factor/analysisABSTRACT
BACKGROUND: Imprint cytology of the thymus has not received much attention. Cytology of the thymus is important because the uninvolved thymus may be needled during aspiration procedures. CASES: In two cases, during surgery for carcinoma of the thyroid, we received thymic tissue mistakenly sampled as a pretracheal lymph node for frozen section to rule out metastasis. Imprint smears were studied. The presence of thymocytes in the cytoplasm of thymic epithelial cells (emperipolesis) was the most significant feature in the imprints. However, it was not detected on histology. CONCLUSION: Thymic epithelial cells provide mechanical support and play a major role in the maturation of lymphocytes (thymocytes). They are observed as emperipolesis on imprint cytology. Its utility in identifying thymic cells in aspiration cytology needs to be investigated.
Subject(s)
Thymus Gland/cytology , Thyroid Neoplasms/pathology , Adult , Biopsy, Needle , Female , Humans , Lymph Node Excision , Male , Thyroid Neoplasms/surgery , ThyroidectomyABSTRACT
BACKGROUND: Though Epstein-Barr virus (EBV) has been linked to classical Hodgkin's disease (cHD), only a proportion of cHD cases show EBV-association. While there has been evidence to suggest a crucial role for EBV in the early phase of cHD evolution, we are unclear whether continued presence of EBV is essential for the maintenance of the neoplasm. We have addressed this issue by investigating the EBV-association in paired samples of cHD obtained at presentation and relapse. MATERIALS AND METHODS: We have analysed lymph node biopsy samples from 23 cases of cHD at presentation and relapse. In situ hybridization with EBER-1 probe and immunostaining with anti latent membrane protein-1 (LMP-1) antibody was performed on the paraffin sections. PCR for EBNA 3C gene was performed for EBV subtype analysis on the DNA extracted from paraffin sections. RESULTS: EBV-association was documented in both the presentation and relapse samples of 14 cases. One case showed loss of EBV-association at relapse. PCR analysable DNA was obtained from both presentation and relapse samples in four of the EBV-associated cases. The EBNA 3C amplimer corresponded to type A strain of EBV in all the samples. CONCLUSION: Loss of EBV-association between presentation and relapse seen in one case implies a hit and run mechanism in EBV-induced lymphomagenesis. Though EBV may be essential early in the evolution of cHD, it may not be required for maintenance of the neoplastic clone. Our study also brings out a speculation that a proportion of EBV-negative cHD could represent loss of EBV in the tumour prior to clinical presentation. Alternatively, an unidentified lymphotropic virus other than EBV might play a pathogenetic role in EBV-negative cHD.
