Cytologic, immunocytochemical and ultrastructural characterization of lymphangioleiomyomatosis cell clusters in chylous effusions of patients with lymphangioleiomyomatosis.
OBJECTIVE
To establish the cytologic and immunocytochemical features of lymphangioleiomyomatosis (LAM) cell clusters (LCCs) and to clarify its diagnostic significance for LAM.


METHODS
We evaluated 17 samples of LAM-associated chylous effisions from 13 patients with LAM. We performed Papanicolaou staining and immunocytochemistry for muscular antigens, melanoma-related antigens, female 'hormone receptors and markers for lymphatic endothelial cells (LECs).


RESULTS
The cytologic features of LCCs were a well-organized, globular cluster consisting of LAM cells enveloped by LECs. The LAM cells were observed to form a tightly cohesive core and had a moderate nuclear/cytoplasmic ratio. These are distinct characteristics from cancer cell clusters. Immunocytochemical examinations revealed the LAM cells to be positive for muscular antigens, melanoma-related antigens and progesterone receptor, but only 2 of 7 specimens were positive for estrogen receptor. The surface monolayer cells were confirmed to be immunopositive for various LEC markers. Ultrastructural study confirmed that LCCs were covered by LECs.


CONCLUSIONS
LCCs were detected in all LAM-associated chylous effusion samples. The cytologic and immunocytochemical examinations of chylous effusions are thus considered to have diagnostic significance for LAM that may therefore enable patients to avoid undergoing such invasive tests as lung biopsies.
Mitani
Keiko
K
Department of Human Pathology, School of Medicine, Juntendo University, and Division of Clinical Laboratory, Juntendo University Hospital, Tokyo, Japan.
Kumasaka
Toshio
T
Takemura
Hiroyuki
H
Hayashi
Takuo
T
Gunji
Yoko
Y
Kunogi
Makiko
M
Akiyoshi
Taeko
T
Takahashi
Kazuhisa
K
Suda
Koichi
K
Seyama
Kuniaki
K
D000328:Adult; D000951:Antigens, Neoplasm / Q000032:analysis; D002915:Chylous Ascites / Q000150:complications / Q000473:pathology*; D042783:Endothelial Cells / Q000648:ultrastructure*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D018192:Lymphangioleiomyomatosis / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D058950:Melanoma-Specific Antigens; D008875:Middle Aged; D009124:Muscle Proteins / Q000032:analysis; D009363:Neoplasm Proteins / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis
D000951:Antigens, Neoplasm; D058950:Melanoma-Specific Antigens; D009124:Muscle Proteins; D009363:Neoplasm Proteins; D011980:Receptors, Progesterone