Lymphangioma involving the mandible: immunohistochemical expressions for the lymphatic proliferation.
We report a case of lymphangioma involving oral mucosa and mandible of an elderly female. The surgical and radiological examinations indicated that the lymphangioma was mainly distributed in the labial mucosa tissue, but had gradually extended into the periosteum and intrabony space of mandible. Immunohistochemical staining was also performed using antiseras of alpha-smooth muscle actin (alpha-SMA), von Willebrand factor (vWF), angiogenin, vascular endothelial growth factor (VEGF), and proliferating cell nuclear antigen (PCNA) to elucidate the pathogenetic implications of the intraosseous lymphangioma. The present case of lymphangioma showed strong immunohistochemical reactivity of angiogenin and vWF, while it showed weak reactions of VEGF and PCNA. The immunostaining of alpha-SMA disclosed an abnormally thinned and discontinuous smooth muscle layer in the lymphatics. Both the X-rays and histological examination showed that the lymphangioma lesion was gradually extending into the adjacent osteoporotic marrow space of mandible. Therefore, we believe that the present case of intraosseous lymphangioma, which showed the harmatomatous growth of the lymphatics into the marrow space of mandible, is closely related to osteoporotic changes of old age.
Department of Oral and Maxillofacial Surgery, College of Dentistry, Kangnung National University, Kangnung, Korea.
Young Wook
YW
Park
Soung Min
SM
Kim
Bong Gi
BG
Min
In Woo
IW
Park
Suk Keun
SK
Lee
D000199:Actins / Q000032:analysis; D000368:Aged; D043925:Angiogenesis Inducing Agents / Q000032:analysis; D001853:Bone Marrow / Q000473:pathology; D016228:Endothelial Growth Factors / Q000032:analysis; D005260:Female; D006222:Hamartoma / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008202:Lymphangioma / Q000473:pathology*; D008206:Lymphatic Diseases / Q000473:pathology; D008221:Lymphoid Tissue / Q000473:pathology*; D008222:Lymphokines / Q000032:analysis; D008336:Mandibular Diseases / Q000473:pathology; D008339:Mandibular Neoplasms / Q000473:pathology*; D009061:Mouth Mucosa / Q000473:pathology; D009062:Mouth Neoplasms / Q000473:pathology*; D009130:Muscle, Smooth / Q000473:pathology; D009361:Neoplasm Invasiveness; D009363:Neoplasm Proteins / Q000032:analysis; D010024:Osteoporosis / Q000473:pathology; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis; D020033:Protein Isoforms / Q000032:analysis; D012259:Ribonuclease, Pancreatic / Q000032:analysis; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D014841:von Willebrand Factor / Q000032:analysis
D000199:Actins; D043925:Angiogenesis Inducing Agents; D016228:Endothelial Growth Factors; D008222:Lymphokines; D009363:Neoplasm Proteins; D018809:Proliferating Cell Nuclear Antigen; D020033:Protein Isoforms; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D014841:von Willebrand Factor; C046366:angiogenin; D012259:Ribonuclease, Pancreatic