Lymphovascular invasion
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Lymphovascular invasion, also lymphovascular space invasion, is (non-hematologic) malignant cells within blood vessels and/or lymphatics. It is abbreviated LVI.
Terminology
Lymphovascular invasion is preferred to vascular invasion, as it is very difficult to differentiate small lymphatics and small vascular spaces.
Microscopic
Rosen criteria for LVI (in the breast):[1][2]
- 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.[3]
IHC
Vascular markers:
- CD31.
- CD34.
Markers with high specific to lymphatic spaces:
- D2-40.
See also
References
- ↑ 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.