Article Text

Download PDFPDF
Lymphatic vascular density and lymphangiogenesis during tumour progression of carcinoma ex pleomorphic adenoma
  1. A B Soares1,
  2. L Ponchio2,
  3. P B Juliano1,
  4. V C de Araújo3,
  5. A Altemani1
  1. 1Department of Pathology, School of Medicine, State University of Campinas (UNICAMP), Campinas, Brazil
  2. 2Centro de Estudos Avançados em Economia Aplicada (ESALQ-USP), Piracicaba, Brazil
  3. 3Centro de Pesquisa São Leopoldo Mandic, Campinas, Brazil
  1. Correspondence to:
    Dr Albina Altemani
    Department of Pathology, School of Medicine, State University of Campinas (UNICAMP), 13084-971 Campinas, SP, Brazil, PO Box 6111; aaltemani{at}


Aims: To assess lymphatic vascular density (LVD) and lymph vessel endothelial proliferation in a series of carcinoma ex pleomorphic adenoma (CXPA) that represents the tumour in the different carcinogenesis phases and tumour progression.

Methods: In 8 cases of early CXPA (intracapsular and minimally invasive tumours), 8 of advanced CXPA (widely invasive tumours) and 10 of pleomorphic adenoma (PA) without malignant transformation, lymphatic vessels and proliferating cells were detected using the antibodies D2-40 and Ki-67 respectively.

Results: Comparing early tumours with advanced ones, LVD was not significantly different at the tumour margin. In contrast, regarding intratumoural lymphatics, PA without malignant transformation and early CXPA contained rare, if any, lymph vessels, whereas in widely invasive carcinomas they were more numerous. However, neither intratumoural nor peritumoural LVD were increased in comparison to adjacent normal salivary gland tissue. In no case did dual immunohistochemistry using D2-40 and the cell proliferation marker Ki-67 reveal the existence of proliferating lymphatics. Carcinomatous emboli were found in peritumoural as well as in intratumoural lymphatics only in advanced CXPA without myoepithelial differentiation.

Conclusion: In CXPA, the lymphatic network is mainly composed of pre-existing lymphatics which are rare in tumours that have not infiltrated outside the confines of the original PA. In the widely invasive CXPA, intratumoural as well as peritumoural lymphatics are a conduit for carcinoma cells, but in carcinomas with myoepithelial differentiation, the neoplastic cells seem to have a lower invasion capacity.

  • CXPA, carcinoma ex pleomorphic adenoma
  • LVD, lymphatic vascular density
  • PA, pleomorphic adenoma
  • lymphangiogenesis
  • carcinoma ex-pleomorphic adenoma
  • pleomorphic adenoma
  • lymph vessel
  • lymphatic vascular density

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Published Online First 1 November 2006

  • Funding: This study was supported by FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo) (grant number 04/07960-0).

  • Competing interests: None declared.