Immunohistochemical clues to the diagnosis of Mondor’s disease of the penis

Abstract

Mondor's disease of the penis is usually a benign, self-limiting process of acute onset. To date, there have been few studies about its diagnosis and treatment. It is difficult to differentiate MD of the penis from sclerosing lymphangitis of the penis, because the symptoms, epidemiology and aetiology are similar, and because veins are histologically very similar to lymphatics. We report a case of MD in which immunochemical markers such as CD31 and D240 allowed us to specifically discriminate between the small vein and lymphatic vessels. This is important not only for the recognition of MD at any site, but for many other diseases in which veins or lymphatic vessels are affected.

Evaluation and Treatment of Penile Thrombophlebitis (Mondor’s Disease)

“…Pathologic analysis of thrombectomy specimens in PMD reveals vein obliteration, endothelial cell enlargement, blood vessel wall thickening with connective tissue proliferation, mixed lymphocytic and histiocytic perivascular infiltrate, and sometimes venous and arterial sclerosis [7]. As previously noted, in classical PMD, the disease is limited to the veins and does not affect lymphatics as in NSVL [7,10,15].…”

“…The result is a smooth, firm cord-like induration often on the penile dorsum. The lesion is skin colored with usually mobile overlying skin and without erythema, and the patient sometimes complains of associated pain [10].…”

“…PMD is typically a selflimited condition. A separate, but similar self-resolving condition, non-venereal sclerosing lymphangitis (NSVL) had been confused for PMD in the past, especially before the use of ultrasound techniques and immunohistochemistry for differentiation [2••, 4••, 10,11]. Despite PMD affecting the superficial veins and NSVL the lymphatics, further complicating the issue is the possibility that the two diseases can co-present.…”

From Furuncle to Axillary Web Syndrome: Shedding Light on Histopathology and Pathogenesis

“…A sclerosing variant of superficial thrombophlebitis may occur over the breast and anterolateral chest wall or over the dorsum of penis and is referred to as Mondor’s disease [13,14]. Alvarez-Garrido et al [14] report a case of Mondor’s disease of the penis, describing the role of immunohistochemical studies in differentiation of this entity from sclerosing lymphangitis of the penis. The authors note that positive immunostaining with CD31 and CD34 along with negative staining for D2-40 suggests a venous origin for the cord and excludes a lymphatic etiology.…”

Lymphangite sclérosante du pénis

“…Si besoin, un examen immunohistochimique pourra orienter vers la nature veineuse et non pas lymphatique du vaisseau lésé, en montrant un marquage des cellules endothéliales par le CD31 et le CD34 et une absence de marquage par l'anticorps D240 [11].…”