[1249] Is Intratumoral (IT) or Peritumoral (PT) Lymphangiogenesis in Low-Grade Salivary Gland Carcinomas Significant?

A Samad, C Singh, JC Manivel, R Gamez, IG Koutlas, SE Pambuccian. Uni of Minnesota, Minneapolis, MN

Background: The prognosis of mucoepidermoid (MEC), acinic cell (ACC) and adenoid cystic carcinoma (ADCY) is dependent on tumor size, nodal metastases and grade. Nodal metastases correlate with lymphatic density (LD) in some tumors like prostate and colon carcinoma but no data on lymphangiogenesis are available in salivary gland carcinomas. The aim of this study was to assess IT or PT lymphatic densities in MEC, ADCY, ACC as compared to pleomorphic adenomas (PA) and determine any relationship between LD and nodal metastases in these tumors.
Design: All ADCY, MEC, ACC and a matching number of PA diagnosed during a 10 year period in our institute were identified and reviewed. Blocks containing normal and tumor interface were immunostained with D-2-40 (Biocare Medical) using Ventana Benchmark XT. Two reviewers quantified lymphatic density (averaged from number of lymphatics in 4 high power fields in “hot spots” identified at low power) in IT and PT tissue (within 10-mm around tumor).
Results: 73% of all malignant tumors and 100% of PA originated in the parotid. 9 cases (6 MEC, 2 ACC, 1 ADCY) had lymph node metastases (LN+) at diagnosis. The lymphatic density is significantly higher in the PT tissue compared to the tumor (p<0.0001) for MEC, ADCY, ACC and PA. The IT and PT lymphatic densities between different malignancies do not show any significant difference (p>0.05) and were not different than the same measurements in PA.

Intratumoral (IT) and Peritumoral (PT) Lymphatic density
Tumor(n=47)Age (mean)M:FIT(Mean+/-SD)PT(Mean+/-SD)p-value
MEC(n=10)52.57:30.40+/-0.323.45+/-1.28<0.0001
ADCY(n=18)488:100.50+/-0.613.83+/-1.48<0.0001
ACC(n=9)424:50.38+/-0.994.00+/-1.16<0.0001
PA(n=10)435:50.55+/-0.643.77+/-1.12<0.0001


No difference in IT lymphatic density was seen between LN+ cases and LN- ones (0.33±0.35 vs.0.48±0.73, p=0.56). The PT lymphatic density was surprisingly significantly lower in LN+ cases than LN- ones (2.67±1.25 vs. 4.05±1.08, p=0.004).
Conclusions: All tumors showed lower IT than PT lymphatic densities but no difference in IT or PT density amongst malignant tumors or between benign and malignant tumors was seen. No correlation between LD and nodal status was found. These results suggest that lymphangiogenesis does not play a major role in aggressiveness of low grade salivary gland carcinomas.
Category: Head & Neck

Wednesday, March 24, 2010 9:30 AM

Poster Session V # 157, Wednesday Morning

 

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