Invasive Micropapillary Carcinoma of the Breast : Association of Pathologic Features With Lymph Node Metastasis

Guo, Xiaojing; Chen, Ling; Lang, Ronggang; Fan, Yu; Zhang, Xinmin; Li, Fu

doi:10.1309/axyy-4ajt-mnw6-frmw

Cited by 60 publications

(87 citation statements)

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“…[7][8][9][10][11] In contrast, invasive micropapillary carcinoma has a high incidence of axillary lymph node metastasis and poor prognosis and the mechanism is still poorly understood. In our previous study, 4 we found that invasive micropapillary carcinoma rich in tumor infiltrating lymphocytes was associated with an increased incidence of lymph node metastasis and an increased number of positive lymph nodes per case. A similar adverse effect of tumor infiltrating lymphocytes was also reported in primary cutaneous melanoma.…”

Section: Discussionmentioning

confidence: 76%

“…3 Invasive micropapillary carcinoma of breast is composed of small clusters of tumor cells lying within clear stromal spaces and exhibits axillary lymph node metastasis with extraordinary frequency. In a previous study of 51 cases of invasive micropapillary carcinoma, 28 cases showed prominent tumor lymphocyte infiltration, 4 yet this group of patients presented with a significantly higher rate of lymph node metastasis than the group without or with scanty tumor lymphocyte infiltration. To explore the potential mechanisms to account for this apparent discordant finding, we compared the immunologic profile and activities of the tumor infiltrating lymphocytes of the 28 cases of invasive micropapillary carcinoma with those in a similar number of cases of medullary carcinoma.…”

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Tumor infiltrating lymphocytes differ in invasive micropapillary carcinoma and medullary carcinoma of breast

et al. 2008

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Tumor infiltrating lymphocytes have been correlated with a better prognosis for some tumors and medullary carcinoma of breast is a good example. However, in a recent study of invasive micropapillary carcinoma of breast, tumor infiltrating lymphocytes were associated with increased lymph node metastasis and a poorer prognosis. To explore possible mechanisms underlying this difference in immune responsiveness and tumor behavior, 28 cases of invasive micropapillary carcinoma with prominent lymphocyte infiltration were compared with 29 cases of medullary carcinoma. In both tumors, the majority of tumor infiltrating lymphocytes were T lymphocytes (Po0.01) with CD8 þ T lymphocytes predominant (Po0.01). Significantly, functional differences in CD8 þ cytotoxic T lymphocytes were identified in the two types of tumor. While lymphocytes infiltrated both the stroma and epithelial components of medullary carcinoma, the tumor infiltrating lymphocytes of invasive micropapillary carcinoma were almost exclusively confined to the stroma. Tumor infiltrating lymphocytes of medullary carcinoma showed stronger expression of FasL than those in invasive micropapillary carcinoma (Po0.01) and medullary carcinoma cells exhibited stronger expression of Fas than invasive micropapillary carcinoma cells did (Po0.01). In the subgroups of tumors with strong ( þ þ / þ þ þ ) Fas expression, double immunohistochemistry revealed that most of the tumor infiltrating lymphocytes in medullary carcinoma, particularly those infiltrating the tumor nests, were CD8 þ cytotoxic T lymphocytes, but not so in invasive micropapillary carcinoma. Furthermore, upregulated expression of perforin, granzyme B and FasL by cytotoxic T lymphocytes was greater in medullary carcinoma than invasive micropapillary carcinoma (Po0.01, respectively). The results suggest that effective immunity provided by tumor infiltrating lymphocytes varies in different tumors and the relative lack of tumor-killing cytotoxic T lymphocytes in invasive micropapillary carcinoma may explain, in part, the adverse association of tumor infiltrating lymphocytes with the biological behavior of invasive micropapillary carcinoma of breast. Modern Pathology (2008Pathology ( ) 21, 1101Pathology ( -1107 doi:10.1038/modpathol.2008 published online 9 May 2008 Keywords: tumor infiltrating lymphocytes; invasive micropapillary carcinoma; medullary carcinoma; breast; laser scanning confocal microscope Local and systemic inflammatory responses play an important role in the progression of a variety of common solid tumors. Tumor infiltrating lymphocytes are believed to represent the local immune response, a key mechanism in controlling tumor growth and metastasis, and an independent prognostic indicator for many tumors.1,2 This is well demonstrated in medullary carcinoma of breast which is characterized by large sheets of poorly differentiated tumor cells and a prominent lymphoplasmacytic infiltrate, rare lymph node metastasis and a good prognosis. 3 Invasive micropapillary carcinoma of breast is composed of sma...

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confidence: 76%

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confidence: 66%

Tumor infiltrating lymphocytes differ in invasive micropapillary carcinoma and medullary carcinoma of breast

et al. 2008

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“…It seems reasonable, therefore, to hypothesize that MTDH could promote the invasion and lymph node metastasis of IMPC through EMT. In addition, the previous studies have demonstrated that there were many microvessel in IMPC [29] and the VEGF-C high expression was associated with lymph node metastasis of IMPC [30] . The significance of MTDH expression was in correlation with VEGF in triple-negative breast cancer [31] .…”

Section: Discussionmentioning

confidence: 99%

MTDH expression in invasive micropapillary carcinoma of the breast

Hao

Yang

Liu

et al. 2011

Clin. Oncol. Cancer Res.

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OBJECTIVE To clarify the expression of MTDH in invasive micropapillary carcinoma of the breast (IMPC) and analyze the relationship between MTDH expression and clinicalpathologic parameters of the IMPC patietns. METHODS The expression of MTDH protein was analyzed using immunohistochemical staining in 86 cases with IMPC and another 86 cases with invasive ductal carcinoma not otherwise specified (IDC-NOS). The association between MTDH expression and clinicalpathologic parameters of the IMPC patients was analyzed. RESULTS Immunohistochemical analysis revealed the high expression of MTDH in 64 of the 86 (64/86, 74.4%) IMPC patients and in 45 of the 86 (45/86, 52.3%) IDC-NOS patients. Statistical analysis showed a statistically significant difference in MTDH expression between IMPC and IDC-NOS (P , 0.05). In IMPC, the expression of MTDH was correlated with lymph nodes metastasis (P , 0.05). The expression of MTDH was negative in normal breast tissue of IMPC and IDC-NOS patients. CONCLUSION High expression of MTDH is one of the molecular mechanisms, which facilitates lymph node metastasis of IMPC, therefore, the expression level of IMPC plays an important role in lymph node metastasis of IMPC.KEY WORDS: breast carcinoma, invasive micropapillary carcinoma, metadherin, lymph node metastases.

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“…Guo ve arkadaşlarının yaptığı bir çalışmada İMPK hücrelerinin yeni lenfatik damar yapımını indükleyen vasküler endotelyal büyüme faktörü-C sentezi yaptığı ortaya konmuştur; yeni yapılan lenfatik damarların tümör invazyonuna daha duyarlı olduğu ve bu yolla lenf nodu metastazını kolaylaştırdığı düşünülmektedir (27). Lenfovasküler invazyon sıklığı, çeşitli çalışmalarda farklı bulunmuş olup %15-80 arasında değişmektedir (1,(6)(7)(8)(9)11,20).…”

Section: Memeni̇n İnvazi̇v Mi̇kropapi̇ller Karsi̇nomuunclassified

Micropapillary carcinoma: pathogenesis, histological and clinical features

Behzatoğlu¹,

Hacıhasanoğlu²

2017

JCurrPath

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ÖzeTİnvaziv mikropapiller karsinom, ilk defa 1993 yılında tanımlanan, meme, mesane, akciğer, tükürük bezleri, over gibi pek çok anatomik bölgede görülen nadir bir karsinom tipidir. Histolojisi, fibrovasküler koru olmayan hücre kümeleri ve onları çevreleyen, lenfatik kanalları andıran boşluklar ile karakterizedir. Mikropapiller karsinom, genellikle bulunduğu organın konvansiyonel karsinomu veya diğer karsinom varyantları ile bir arada görülmektedir. Saf mikropapiller karsinom oldukça nadirdir. Odaksal da olsa mikropapiller büyüme paterni gösteren tümörlerin lenfovasküler invazyon, lenf nodu metastazı ve uzak metastaz yapma eğilimi konvansiyonel karsinomlardan yüksektir. tümöründe invaziv mikropapiller komponent bulunan hastalar ileri evrede prezente olmakta ve aynı organın konvansiyonel karsinomlarıyla karşılaştırıldığında daha düşük oranda sağkalım göstermektedir. Agresif seyir gösteren bu karsinom tipinin tanınması hasta takibi ve tedavi açısından önem taşımaktadır. Bu derlemede mikropapiller karsinomun patogenezine değinilmiş, farklı organ ve bölgelerdeki mikropapiller karsinomların klinik, histolojik ve immunohistokimyasal özellikleri tartışılmıştır.Anahtar Sözcükler: Mikropapiller karsinom, Patogenez, İmmunhistokimya, Klinik, tedavi aBSTRaCT Invasive micropapillary carcinoma is a rare variant of carcinoma which was first described in 1993. It has been recognized in various anatomic sites including breast, urinary bladder, lung, salivary glands and ovary, since then. Histologically, it is characterized by tight clusters of neoplastic cells and clear spaces around them resembling lymphatic vessels. Micropapillary growth patern is usually mixed with conventional carcinoma or other variants of carcinoma. Pure micropapillary carcinoma is very rare. tumors with micropapillary growth pattern tend to make lymphovascular invasion, lymph node metastasis and distant metastasis more frequently than conventional carcinomas. Furthermore, patients present with high-stage disease and have poor prognosis compared to patients with conventional carcinoma of the same organ. Recognition of this aggressive type of carcinoma is important for treatment choice and clinical follow-up of the patient. this review discusses the pathogenesis, clinical, morphological, and immunohistochemical features of micropapillary carcinoma of various organs/sites. GİRİşİnvaziv mikropapiller karsinom (İMPK), özellikle son 20 yılda oldukça ilgi çeken agresif bir özel karsinom tipidir. Özellikle ileri evrede saptanması, yüksek lenfovasküler invazyon, lenf nodu metastazı ve uzak metastaz oranları ile dikkat çeken mikropapiller karsinom, ilk kez 1993 yılında Siriaunkgul ve tavassoli tarafından memede tarif edilmiştir (1). Memede farklı bir antite olarak tanımlanmasından sonra mesane, akciğer, tükürük bezi, gastrointestinal sistem gibi birçok anatomik bölgede çok sayıda olgu bildirilmiştir (1-21). Bu yazıda genelde İMPK ifadesini daha çok kullanacağız. Çünkü meme ve tükürük bezi duktal karsinomlarında ve mesane ürotelyal karsinomlarında in situ karsinom o...

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Invasive Micropapillary Carcinoma of the Breast : Association of Pathologic Features With Lymph Node Metastasis

Cited by 60 publications

References 19 publications

Tumor infiltrating lymphocytes differ in invasive micropapillary carcinoma and medullary carcinoma of breast

Tumor infiltrating lymphocytes differ in invasive micropapillary carcinoma and medullary carcinoma of breast

MTDH expression in invasive micropapillary carcinoma of the breast

Micropapillary carcinoma: pathogenesis, histological and clinical features

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