title: Lymphatic invasion and angiotropism in primary cutaneous melanoma.
abstract: Access of melanoma cells to the cutaneous vasculature either via lymphatic invasion or angiotropism is a proposed mechanism for metastasis. Lymphatic invasion is believed to be a mechanism by which melanoma cells can disseminate to regional lymph nodes and to distant sites and may be predictive of adverse outcomes. Although it can be detected on hematoxylin- and eosin-stained sections, sensitivity is markedly improved by immunohistochemistry for lymphatic endothelial cells. Multiple studies have reported a significant association between the presence of lymphatic invasion and sentinel lymph node metastasis and survival. More recently, extravascular migratory metastasis has been suggested as another means by which melanoma cells can spread. Angiotropism, the histopathologic correlate of extravascular migratory metastasis, has also been associated with melanoma metastasis and disease recurrence. Although lymphatic invasion and angiotropism are not currently part of routine melanoma reporting, the detection of these attributes using ancillary immunohistochemical stains may be useful in therapeutic planning for patients with melanoma.
authors.affiliation: Dermatopathology Unit, Pathology Service, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Andrea P
authors.initials: AP
authors.lastname: Moy
authors.affiliation: Dermatopathology Unit, Pathology Service, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Lyn M
authors.initials: LM
authors.lastname: Duncan
authors.affiliation: Dermatopathology Unit, Pathology Service, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kraft
mesh_terms: D002465:Cell Movement; D018572:Disease-Free Survival; D006651:Histocytochemistry; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000098:blood supply / Q000378:metabolism / Q000473:pathology*; D008562:Membrane Glycoproteins / Q000032:analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009389:Neovascularization, Pathologic / Q000378:metabolism / Q000473:pathology*; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000032:analysis; D011379:Prognosis; D009418:S100 Proteins / Q000032:analysis; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000098:blood supply / Q000378:metabolism / Q000473:pathology*; D033921:Vesicular Transport Proteins / Q000032:analysis; D000098853:Podoplanin
chemical_list: D008562:Membrane Glycoproteins; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D009418:S100 Proteins; D033921:Vesicular Transport Proteins; C119248:LYVE1 protein, human; C117468:PDPN protein, human; D000098853:Podoplanin; C110294:S100A1 protein