title: Angiogenic and lymphangiogenic microvessel density in recurrent pleomorphic adenoma.
abstract: BACKGROUND
  Recurrent pleomorphic adenoma (RPA) is an uncommon and challenging disease. The aim of this study was to determine if there is a difference between RPA and the pleomorphic adenoma (PA) without recurrence related to tumor blood and lymphatic vascularization. Moreover, we compared the microvessel density (MVD) between cell-rich areas (predominance of epithelial cells) and cell-poor areas (predominance of myxoid and chondroid areas) of the stroma of PA and RPA. In addition, immunohistochemical staining for the Ki-67 antigen was conducted simultaneously to evaluate cell proliferation in PA and RPA.
  
  
  METHODS
  A total of 19 cases of PA and 24 cases of RPA, blood, and lymphatic vessels were analyzed by immunohistochemical technique using the antibodies CD34, CD105, D2-40, and Ki-67.
  
  
  RESULTS
  Comparing no recurrent with recurrent tumor, no significant difference was found in terms of lymphatic vessel density, MVD, and proliferation index. When MVD and proliferation index were compared with different areas in cellular composition (cell-rich and cell-poor areas), there was a significant difference in PA, as well as in RPA.
  
  
  CONCLUSIONS
  This study shows that although RPA presents more aggressive clinical behavior than PA, there is no difference between tumor blood and lymphatic vascularization, suggesting that there is no correlation between vascularity and risk of recurrence. Furthermore, vascularized stroma in PA, as well as RPA, depends on the proportion of the cellular composition.
authors: Centro de Pesquisa São Leopoldo Mandic, Rua José Rocha Junqueira 13 Ponte Preta, 13045-755, Campinas, SP, Brazil. andresabs@hotmail.com
authors: Andresa B
authors: AB
authors: Soares
authors: Vera C
authors: VC
authors: de Araújo
authors: Priscila B
authors: PB
authors: Juliano
authors: Albina
authors: A
authors: Altemani
mesh_terms: D008949:Adenoma, Pleomorphic / Q000098:blood supply / Q000378:metabolism / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000378:metabolism; D049109:Cell Proliferation; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D042583:Lymphangiogenesis / Q000502:physiology; D042601:Lymphatic Vessels / Q000378:metabolism / Q000473:pathology; D008297:Male; D055806:Microvessels / Q000378:metabolism / Q000503:physiopathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000098:blood supply* / Q000378:metabolism / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000378:metabolism / Q000473:pathology*; D010307:Parotid Neoplasms / Q000098:blood supply / Q000378:metabolism / Q000473:pathology*; D018709:Statistics, Nonparametric; D013365:Submandibular Gland Neoplasms / Q000098:blood supply / Q000378:metabolism / Q000473:pathology*
chemical_list: D015703:Antigens, CD; D019394:Ki-67 Antigen