Periacinar Retraction Clefting and D2-40 Expression in Prostatic Adenocarcinoma

Abstract

Retraction clefting is known to appear in various types of tumors, but it has only recently been recognized as a specific histological phenomenon. Previously, it was considered merely a laboratory procedure artifact, but lately, there have been some assumptions that peritumoral retractions actually represent lymphatic spaces. In our study, we analyzed neoplastic glands in 52 specimens of prostatic adenocarcinoma. Immunohistochemical analysis was performed using D2-40 antibody, to highlight lymphatic endothelium and thereby differentiate actual lymph vessels or lymphovascular invasion from periacinar retractions. Our results showed that the number of lymph vessels was significantly lower in tumorous tissue compared to adjacent normal prostatic tissue. On the other hand, the number of lymph vessels in tumorous tissue was significantly higher than the number of lymph vessels mimicking periacinar retractions. Overall, the number of lymph vessels mimicking periacinar clefts was particularly low. These results are in accordance with our previous studies, which had shown that periacinar clefting appears due to lack of basal cells and stromal changes around tumorous acini. Also, these results support our hypothesis that retractions do not represent lymph vessels but should be considered a distinct entity, which is proven to be helpful both as diagnostic and predictive factor.

Prognostic Significance of Lymphatic Vessel Density Detected by D2-40 and Its Relation to Claudin-4 Expression in Prostatic Adenocarcinoma

“…8 Therefore, immunohistochemical detection of D2-40 antibody is useful to differentiate actual lymph vessels and lymphatic invasion from periacinar retractions. 9…”

Periacinar retraction artifact of the prostate

“…Irie et al (6) proposed that retraction artifact around tumorous tissue actually represent lymph vessel compartments and their appearance connected with lymph vessels invasion in breast carcinoma. In order to investigate this hypothesis we analyzed relationship between retraction artifact and expression of immunohistochemical marker of lymph vessels D2-40 in prostatic carcinoma (71). Neoplastic glands were analysed in 25 paraffin sections from radical prostatectomy specimens with prostatic adenocarcinoma diagnosis.…”

Exploring the Relationship between E-Cadherin and β-Catenin Cell Adhesion Proteins and Periacinar Retraction Clefting in Prostatic Adenocarcinoma

“…Three established diagnostic criteria for prostatic adenocarcinoma are the infiltrative growth pattern, the absence of a basal cell layer, and the presence of macro nucleoli [ 1 ]. Periacinar retraction cleftings, also known as retraction artifacts, periacinar halos, or cleft-like spaces, play a significant role in supporting the histopathological diagnosis of prostatic adenocarcinoma [ 1 , 2 , 3 , 4 , 5 ]. These clefts manifest as neoplastic cells “pull away” from the surrounding stroma, creating halos around the acini.…”

“…Moreover, the so called retraction artifacts are suggested to represent an early stage of lymphovascular invasion in breast carcinoma. Ulamec et al [ 4 ], utilizing the D2-40 antibody to highlight lymphatic endothelium to differentiate between authentic lymph vessels or lymphovascular invasion and periacinar retraction clefts, observed a significant reduction in the number of lymph vessels in prostatic adenocarcinoma compared to the adjacent nonneoplastic prostatic tissue. As a result, they concluded that retraction clefts should be regarded as a distinct entity in prostatic adenocarcinoma.…”