eISSN: 2084-9869
ISSN: 1233-9687
Polish Journal of Pathology
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1/2016
vol. 67
 
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abstract:
Original paper

Heterogeneous vascular patterns in renal cell carcinomas

Ovidiu Ferician
,
Anca Maria Cimpean
,
Amalia Raluca Ceausu
,
Alis Dema
,
Marius Raica
,
Alin Cumpanas

Pol J Pathol 2016; 67 (1): 46-53
Online publish date: 2016/05/10
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The present study proposes a classification of renal cancer tumor blood vessels according to their morphology and maturation grade. We identified four vascular patterns: reticular, diffuse, fasciculated and trabecular. The reticular pattern was present in 63% of cases, being characterized by the predominance of mature CD34+/SMAct+ tumor vessels, highly interconnected. For this pattern, 74% of cases had vascular invasion, and a significant correlation was observed between tumor grade and immature state of tumor vessels (p = 0.022). The diffuse pattern was observed in 23% of cases and was characterized by non-interconnected vessels predominantly of mature CD34+/SMAct+ type and vascular invasion in 64% of cases. Only 8% of cases, had a fasciculate model of vessels distribution, all of them being of mature type, located in the connective axis of papillary renal tumors. For this pattern vascular invasion was found in 50% of cases. In 6% of cases a trabecular pattern was observed and the lowest rate of vascular invasion was registered. We defined here four distinct vascular patterns in renal cell carcinomas showing a strong impact on vascular invasion. A complete morphological and molecular characterization of tumor vessels would be beneficial in elucidating the mechanisms that underlie the ineffectiveness of antiangiogenic/antitumor therapies.
keywords:

renal cell carcinoma, CD34, SMAct, vascular pattern

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